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Microkeratome Vs. Intralase
The Microkeratome Wins Over Intralase
Transient light sensitivity A syndrome investigators are calling transient light sensitivity has been identified as a postoperative complication of IntraLase flap creation. TLS symptoms manifest 2 to 6 weeks after surgery. Patients would walk into the office with two pairs of sunglasses on and a baseball cap," said Brian R. Will, MD, director of Will Vision & Laser Centers in Vancouver, Wash. "No one knew what to make of the symptoms - light sensitivity, preserved visual acuity and no slit-lamp findings." Dr. Will coined the term track-related iridocyclitis and scleritis (TRISC) syndrome to describe the condition he thought was due to gas bubbles and debris migrating toward the limbus during LASIK with IntraLase.
It also takes much longer to create the flap prolonging the procedure and sometimes causing dehydration of the cornea, which can vary results. With the chance of creating a partial flap by most microkeratomes in a skilled surgeon's hand being well under one percent, and the fact that multiple heads can be used to provide different flap thicknesses, most surgeons opt for using a mechanical microkeratome versus the Intralase.
The suction ring for the INTRALASE FS laser is in place longer than that of a mechanical microkeratome (40 to 60 seconds total time), subconjunctival hemorrhage is more likely to occur. according to Daniel b. Goldberg, Md, Facs Most laser users recommend reducing this risk by instilling vasoconstrictors preoperatively.
Lifting the flaps is difficult due to the induced fibrosis.
On electron microscopy the interface is not as smooth as with a Microkeratome.
Another disadvantage is the cost of an additional $400-$500 per eye the Intralase commands.
Compared to 5 years ago when Intralase technology was introduced there are better options if Microkeratome needs to be avoided. If cornea is thin than advanced surface ablation or SUPERLASIK™ can be done.
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