All-Laser Vs Microkeratome Lasik
The improved vision that results from LASIK surgery with a microkeratome is achieved in two steps. First, the surgeon uses a microkeratome to expose the inner cornea, creating a thin flap of corneal tissue. Then, the cornea is reshaped using an excimer laser. The creation of the corneal flap with a microkeratome is one of the most important aspects of laser vision correction, and must be performed precisely and accurately.
What is a Microkeratome?
A microkeratome is a precise, hand-held surgical instrument with an oscillating metal blade. It is used to separate the surface layers of the cornea and create a corneal flap during the first step of laser vision correction surgery. First, the microkeratome is placed over the eye, then suction is applied so that the microkeratome is held perfectly still during the procedure. The microkeratome creates a hinged flap, which is laid back while the excimer laser sculpts the cornea into the optimal shape. Once the cornea is re-sculpted into a shape that improves your vision, the tissue is repositioned and healing begins. Visit the LASIK procedure page for a complete step-by-step explanation of LASIK vision correction.
The Modern Microkeratome
In recent years, great advancements have been made in the microkeratome. Laser vision correction is now more accurate and convenient than ever. The newest microkeratomes available on the market offer consistency, precision, and fewer complications.
What Qualities Make a Good Microkeratome?
The factors that determine the quality of a microkeratome are related to its stability and consistency in creating the corneal flap. The newest and best microkeratomes focus on creating corneal flaps that are uniform in thickness, with proper suction maintained throughout the laser vision correction procedure. Dr. Mneimneh uses one of the most state-of-the-art models available today, the WaveLight Rondo.
The WaveLight Rondo microkeratome has an innovative design that allows the surgeon to view the flap as is being created, providing greater accuracy. In addition, the quality of the cut and the predictability of flap thickness have been proven in studies to be better and more consistent than with other microkeratomes. The WaveLight Rondo also offers the surgeon greater control over the flap and hinge size.
Advantages of the Microkeratome
There are several advantages of using the microkeratome in laser vision correction. Compared with other options, such as "bladeless LASIK or All-Laser Lasik”, the microkeratome method is generally faster and more comfortable for the patient. The microkeratome procedure typically lasts about five seconds, compared with 15-20 seconds with IntraLase®. In addition, less suction is necessary with the microkeratome procedure, and less inflammation occurs afterward.
Complications Associated with the Microkeratome
Though rare, there are some potential post-LASIK complications that can occur with the microkeratome, such as the risk of a partial flap, hole in the flap, and other flap complications. A laser flap is the same thickness at the center as it is at the periphery as well as the flap produced by the WaveLight Rondo microkeratome.
The All-Laser LASIK Option
Many surgeons agree that the creation of the flap in the cornea is the most critical step in laser vision correction. In 1999, a type of high-energy laser, called a femtosecond laser or IntraLase®, was created for use as an alternative to the traditional microkeratome blade. Often referred to as "bladeless LASIK,” this procedure is controlled by a computer, which allows the doctor to predetermine specific aspects of the flap, such as thickness and circumference. The IntraLase ® procedure may be a good choice for patients who are not ideal candidates for traditional laser vision correction with a microkeratome.
While this is a very exciting technology, and the 'bladeless' marketing campaign has been very effective, the real benefits may be small compared to current-technology mechanical microkeratomes. Reasonable professionals including very experienced LASIK surgeons will differ in their opinions about the merits of IntraLase "All-Laser" LASIK compared to other options, especially with the evolution of the Wavelight Rondo, Moria and other brand of Microkeratomes available now in our hands.
The equipment is also quite costly; so an added fee is passed along to the consumer.
The popularity of this process will significantly increase with the next more advanced generations of fentosecond lasers, while the cost to provide the technology decreases.
Ask Dr. Mneimneh
The best way to find out what kind of technology is appropriate for your case is to speak to Dr. Mneimneh. He will tell you more about the microkeratome and other laser vision correction options. He will carefully explain the potential merits of the technology to you at the time of your consultation.
Feel free to contact us.