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Intralase Lasik vs. Microkeratome Lasik

Intralase Lasik vs. Microkeratome Lasik

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LASIK is a laser vision correction procedure that corrects nearsightedness, farsightedness, and astigmatism. LASIK has been used for years and is quite popular. Millions of patients have benefited from this state of the art procedure. The first step of LASIK is to create a thin flap in the superficial layers of the cornea. This flap can be made with a metal microkeratome that has an oscillating blade or with Intralase, a bladeless laser.

Initially, microkeratomes were the only way to make a flap in LASIK. Results were good, but complications from the blade microkeratome did happen. A microkeratome has many moving metal parts and the blade is inserted and must oscillate freely. There were problems with quality control with some of the blades. Also, metal fatigue would cause variability in performance of the microkeratome.

The shape of the cornea also influenced the outcome of the flap. Steep corneas were more inclined to have buttonholes and flat corneas were more likely to have free flaps. There were incomplete flaps when the machine did not complete a pass and some flaps were cut in an irregular fashion from a poor blade, poor oscillation, or suction break during the pass. Although these complications were relatively rare, any busy LASIK surgeon has seen all of them, according to Dr. Jeffrey Martin.

With the creation of Intralase, LASIK surgeons are able to make a flap with laser. The laser creates small cavitation bubbles that string together to make a flap. There are no moving parts and the shape of the cornea does not make a difference in the flap creation. Intralase flaps are planar so that there are less higher order aberrations induced. Microkeratome flaps were meniscus shaped and did induce higher order aberration. With Intralase, flap complications are less common and more obvious because the entire flap creation is visible to the surgeon. The chance of free flap or buttonholes is very unlikely and the flap is thinner and more consistent.

For these reasons, Intralase is the better choice for creation of the flap, according to Dr. Jeffrey Martin. Dr. Martin converted to 100 percent Intralase at our Long Island LASIK clinic about four years ago.

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