ASA Allegretto

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ASA Allegretto

Postby GeneralPatientInquiry » Mon Jun 05, 2006 5:34 am

I've been surfing a lot to get information on Lasik etc and I learned of ASA= Advanced Surface Ablation which is supposed to be a mix of Lasik & PRK. The eye institute uses the Allegretto Wave Laser with ASA. What do you know about it? Since they are not creating a flap it is supposed to be so much safer and better.
Thanks for your advice.
This post is a reprint of a previously requested inquiry received by via email.
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Postby LasikExpert » Mon Jun 05, 2006 5:36 am

Advanced Surface Ablation (ASA) is a simplified way to describe PRK, LASEK, or Epi-LASIK with today's laser equipment. There is no ASA surgical procedure. ASA means one of the three surgical techniques that do not use a flap of stromal corneal tissue. That has both advantages and disadvantages.

In PRK the entire outer layer of corneal cells - epithelial layer - is removed and the laser treatment is performed where the cells were located. After a few days the cells regenerate and cover the treatment area.

For patients with over 6.00 diopters of correction, PRK tends to cause late-onset corneal haze. It is possible for the doctor to apply Mitomycin C intraoperatively to help prevent haze, but Mitomycin C is very strong medicine that may be appropriate when needed, but should be avoided if possible.

With Lasik, a flap of stromal tissue is created. This stromal flap tends to "fool" the eye into not knowing it has had surgery. The healing response is different and haze is rare with Lasik.

To help reduce the probability of corneal haze but use a surface ablation technique, LASEK was developed. In LASEK the epithelial cells are not destroyed and removed, but are weakened with an alcohol mixture, moved aside, then returned over the treatment area.

Epi-Lasik uses a microkeratome with a special blunt blade that scrapes the epithelial layer off in one sheet, very much like a Lasik flap, which is moved aside and then repositioned after laser treatment. It is LASEK with a more intact epithelium.

PRK, LASEK, and Epi-Lasik all do not require the deeper stromal tissue flap that LASIK needs. Without this flap, there is no possibility of any Lasik flap related problem during surgery or at any time in the patient's life. Remember that once you have had Lasik, you have always had Lasik.

The Allegretto laser was shown in FDA clinical trials to provide outcomes equal to or better than other lasers.

If your prescription is less than 6.00 diopters, then PRK, LASEK, or Epi-Lasik may be an appropriate choice. If slightly more than 6.00, then Mitomycin C may be required. If significantly more than 6.00, then Lasik is probably going to be the better choice because of the elevated probability of corneal haze with the surface ablation techniques. If much more than 6.00 diopters, it may be that none of these procedures is appropriate.
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