Avoiding LASIK Flap Complications
Submitted by Dr. Dean Dornic on Sun 03/18/2012 - 12:28
Most patients know that there are two steps to the LASIK procedure. The first step, and the one most likely to lead to a complication, is the creation of a LASIK flap. LASIK flap complications are basically one of two types: an irregular/inadequately sized flap or a flap that slips after it is replaced. Traditionally the LASIK flap was cut with an instrument with a rapidly vibrating blade, the microkeratome. Various “tweaks” to microkeratome technology have occurred over the years in an effort to make this step safer and more precise but using a blade to create a flap limits the ability to customize the flap to a patients unique corneal architecture.
A few years ago, the femtosecond laser was introduced as a new method to create a corneal flap. The Ziemer Corporation introduced a laser that essentially replicates a blade in cutting a flap but does so more precisely. However, both of the basic types of flap complications: irregular/inadequately sized flaps and slipped flaps can still occur with similar frequency to the best microkeratome.
The IntraLase corporation, however, took a different approach to flap creation. Their femtosecond technology used an “inside-out” approach. Unlike the Ziemer laser, flap creation is visible to the surgeon. Flap creation is a result of closely spaced “bubbles” that are closely spaced. This means that flap creation is not complete until the perforations are broken by the surgeon using a thin spatula. Why is this important? Because it give an opportunity for a second chance. In addition, the configuration of the flap is similar to a manhole rather than the single plane cut of the Ziemer laser. This innovative approach means that the flap is less likely to slip.
Both the Ziemer laser and IntraLase laser are capable of making a flap. Only the IntraLase laser decreases the incidence of irregular and slipped flaps.
For more on LASIK technology download the free LASIK ebook here:
To watch a video on a LASIK flap made with an IntraLase laser, click here: LASIK with the iFS IntraLase laser