Opinions about IntraLase

Discussion in 'Optometry Archives' started by Pauli Soininen, Apr 16, 2005.

  1. Pauli Soininen, Apr 16, 2005
    #1
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  2. Pauli Soininen

    Dr. Leukoma Guest

    The Intralase uses a femtosecond pulsed YAG laser to cleave the corneal
    stroma at a predetermined depth. It does this by creating tiny
    contiguous bursts of energy in a plane. The claims are for greater
    accuracy and precision in flap thickness resulting in improved safety.

    Ophthalmic conferences are often used by the manufacturers to showcase
    new technology, be it new lasers or new contact lenses. Although the
    studies purport improved visual results over standard
    microkeratome-created flaps, I would want to know how many of those
    referenced studies were sponsored by the manufacturer, and how many of
    the authors were paid consultants. I have heard that visual recovery
    following Intralase-created flaps takes longer, presumably because of
    the effects of the gaseous by-products created in the process.

    We will probably hear a volley from the microkeratome manufacturers.

    DrG
     
    Dr. Leukoma, Apr 16, 2005
    #2
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  3. Pauli Soininen

    RM Guest

    I work part-time in a practice that does refractive surgery. Both intralase
    and the traditional ablations.

    Although I don't know of any studies, my opinion is that many of the
    difficulties patients have with LASIK are due to imperfect mechanical
    microkeratome cuts-- button holes, off center ablations, etc. I believe,
    based solely upon my personal experience, that intralase is a definite
    incremental improvement in the LASIK procedure. If I were going to get
    LASIK, I would prefer it.
     
    RM, Apr 17, 2005
    #3
  4. my opinion is that many of the difficulties patients have
    As I'm interested in the very details about all that is related to the
    subject; what do you mean by button holes? And why do you think the flap has
    something to do with off center ablations (actually I don't know if the
    centration is measured from the flap cut but I would imagine it's not)? The
    flap cut radius is about 1mm or so bigger than the treated area (at least in
    my case).
     
    Pauli Soininen, Apr 17, 2005
    #4
  5. Pauli Soininen

    Dr. Leukoma Guest

    You're probably right about some of the advantages...although one of my
    current cases is a decentered Intralasik.

    DrG
     
    Dr. Leukoma, Apr 17, 2005
    #5
  6. You're probably right about some of the advantages...although one of
    Does a patient with decentered LASIK have often (or always) a starburst/halo
    pattern that is correspondingly "decentered" as in not equally around a
    bright object? Or does decentration symptoms have anything to do with the
    shape of starburst/halo?
     
    Pauli Soininen, Apr 17, 2005
    #6
  7. Pauli Soininen

    Dr. Leukoma Guest

    Yes. The tail of the comet is typically opposite to the direction of
    decentration. This may not always be the case, since other aberrations
    may be superimposed.

    DrG
     
    Dr. Leukoma, Apr 17, 2005
    #7
  8. Yes. The tail of the comet is typically opposite to the direction of
    Thank you. And when the decentration is fixed by making another, corrective
    ablation, what kind of improvement in sight can be expected? I would imagine
    there would not necessarily be other improvement than reshaping/reducing the
    halo (and thus maybe slightly improving acuity) unless a larger optical zone
    of full refractive correction is made.

    Is the flap openable in the same way months after surgery with both
    IntraLase and non-IntraLase cases?
     
    Pauli Soininen, Apr 17, 2005
    #8
  9. Pauli Soininen

    Dr. Leukoma Guest

    Most surgeons refer to Intralase flaps as velcro flaps. They probably
    are not as easy to lift as microkeratome flaps months after surgery.

    Don't assume that any decentration can be fixed with another surgery.
    It's not so easy and not so predictable.

    DrG
     
    Dr. Leukoma, Apr 17, 2005
    #9
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