What is IntraLase?

Every LASIK eye surgery starts with Step One - the creation of a corneal flap . Doctors have traditionally performed Step One using a hand-held device with an oscillating metal blade, called a microkeratome . Results were considered good.

But that was before IntraLase.

IntraLase makes Step One your first step to all that better vision brings by replacing the hand-held microkeratome blade with a silent, computer-guided laser. Why? Because with the precision of the laser, you can now have greater assurance of a safer procedure and an excellent result.

With IntraLase, a special laser is used instead of a blade to create the flap. Then the usual excimer laser does the ablation. So in the IntraLase procedure, two different lasers are used, which is why it is sometimes promoted as "bladeless" or "all-laser" LASIK. As in typical LASIK, the flap then is replaced to serve as a type of natural "bandage" for healing.

While LASIK complications are relatively rare, they are sometimes associated with the oscillating blade used with traditional microkeratomes. Metal blades might create uneven flap edges, resulting in abnormal corneal surfaces and vision defects such as irregular astigmatism.

Metal blades also have been associated with formation of incomplete or improperly formed "buttonhole" flaps that can cause vision-threatening scars. Many eye surgeons report these types of complications are far less likely with laser-created flaps.

As a replacement for microkeratomes, IntraLase creates flaps through infrared laser energy that inserts a precise pattern of tiny, overlapping spaces just below the corneal surface. The IntraLase laser operates at extremely high speeds (pulses of one quadrillionth of a second), allowing tissue to be targeted and divided at a molecular level without heat or impact to surrounding tissue.

Studies indicate that IntraLase is associated with significantly fewer overall LASIK complication rates. Nevertheless, eye surgeons recently have reported one postoperative complication of unusual light sensitivity such as photophobia that appears unique to the use of the IntraLase in LASIK. Published reports mention this complication has occurred in as few as 1% or as many as 20% of patients undergoing LASIK with IntraLase, according to an article in Review of Ophthalmology , October 2004. (The 20% figure was reported by one surgeon, whose IntraLase laser was replaced by the company because compared with other surgeons' experiences, the figure was abnormally high, according to the article.)

However, many eye surgeons report that the photophobia complication is temporary and can be resolved with steroidthe article.)

However, many eye surgeons report that the photophobia complication is temporary and can be resolved with steroid treatment (eye drops) lasting a few weeks. Eye surgeons favoring IntraLase emphasize that light sensitivity is a transient side effect that soon resolves, unlike more serious and potentially permanent vision-threatening complications that might result from defective flaps.