iLasik Bladeless Surgery

Lehmann Eye Center is proud to offer IntraLase to our patients. All-laser LASIK is the latest technological breakthrough in LASIK. Now we can perform an all-laser, LASIK procedure. Laser Vision Correction is often associated solely with the Excimer laser, but there are actually two very important steps in correcting your vision:

1. Creating a very thin flap of tissue that is folded back during treatment.
2. Reshaping the exposed surface with the Excimer laser and replacing the flap.

Until now, the flap has been created with a mechanical, bladed device called a microkeratome. With the bladed style microkeratome there was an increased risk of complications such as corneal abrasions, irregular flaps, as well as button-hole flaps. All-laser LASIK offers our patients increased safety by eliminating the blade.

Advantages of All-Laser LASIK

1. Increased Safety: Because there is no variability in blade quality with the all-laser LASIK procedure, there is little or no risk of flap irregularities. The all-laser approach allows our surgeons at Lehmann Eye Center to design the flap specifically to your eyes and visual needs.
2. Increased Precision: All-laser LASIK offers the ability to create a flap of uniform thickness at a preprogrammed depth. The traditional style microkeratomes did not account for the curvature of the cornea and created a meniscus style flap, with the edges somewhat thicker than the center. Any variation in flap thickness will result in a variation of your visual outcome. Because we know exactly what depth the flap is being created, we are able to preserve the most corneal tissue following the procedure, leaving each patient with a stronger, more stable eye.
3. Less Invasive: All-laser LASIK is a much less invasive procedure than traditional LASIK. With traditional LASIK, the flap was created with a device that was fashioned after a carpenter's plane. As it glided across the cornea it was possible to create an abrasion on the front of the eye. Patients experienced quite a bit of pain as this abrasion healed. With all-laser LASIK, our surgeons pass the laser through the cornea and create small bubbles at a pre-programmed depth without applying friction to the front layer of the eye, a much more comfortable approach for a patient.
   
   

    

IntraLASIK^® software directs the IntraLase^® FS Laser to optically focus its beam into a tiny, 3 micron spot of energy that passes harmlessly through the outer layers of the cornea until reaching its exact focal point within the stroma (central layer of the cornea). The Intralase^® laser allows for optimal focus.

In an "inside out" process, the laser beam creates a dissection plane by forming an interconnecting series of bubbles (made of carbon dioxide and water vapor). The Intralase^® laser beam stacks a pattern of bubbles along the periphery of the ablation plane, leaving an uncut section of tissue to act as a hinge. As with a traditional LASIK approach, the surgeon then folds the tissue back to expose the underlying corneal layer to prepare for the excimer laser treatment that will re-shape the cornea.To learn more about Intralase®, call our office at 936-569-8278.

Risks & Contraindication

The FS and iFS Laser systems are ophthalmic surgical lasers indicated for use in patients undergoing surgery or treatment requiring the initial lamellar resection of the cornea.  Contraindications may include corneal edema, glaucoma and keratoconus.  Risks and complications may include corneal pain, flap tearing and epithelial ingrowth.  Consult with your eye care professional for a complete listing of contraindications and risks.  U.S. federal law restricts this device to sale, distribution and use by or on the order of a physician or other licensed eye care practitioner.

Most patients are very pleased with the results of their refractive surgery. However, like any other medical procedure, there are risks involved. That's why it is important for you to understand the limitations and possible complications of refractive surgery. Before undergoing a refractive procedure, you should carefully weigh the risks and benefits based on your own personal value system, and try to avoid being influenced by friends that have had the procedure or doctors encouraging you to do so.

• Some patients lose vision. Some patients lose lines of vision on the vision chart that cannot be corrected with glasses, contact lenses, or surgery as a result of treatment.
• Some patients develop debilitating visual symptoms. Some patients develop glare, halos, and/or double vision that can seriously affect nighttime vision. Even with good vision on the vision chart, some patients do not see as well in situations of low contrast, such as at night or in fog, after treatment as compared to before treatment.
• You may be under treated or over treated. Only a certain percent of patients achieve 20/20 vision without glasses or contacts. You may require additional treatment, but additional treatment may not be possible. You may still need glasses or contact lenses after surgery. This may be true even if you only required a very weak prescription before surgery. If you used reading glasses before surgery, you may still need reading glasses after surgery.
• Some patients may develop severe dry eye syndrome. As a result of surgery, your eye may not be able to produce enough tears to keep the eye moist and comfortable. Dry eye not only causes discomfort, but can reduce visual quality due to intermittent blurring and other visual symptoms. This condition may be permanent. Intensive drop therapy and use of plugs or other procedures may be required.
• Results are generally not as good in patients with very large refractive errors of any type. You should discuss your expectations with your doctor and realize that you may still require glasses or contacts after the surgery.
• For some farsighted patients, results may diminish with age. If you are farsighted, the level of improved vision you experience after surgery may decrease with age. This can occur if your manifest refraction (a vision exam with lenses before dilating drops) is very different from your cycloplegic refraction (a vision exam with lenses after dilating drops).

Long-term data are not available. LASIK is a relatively new technology. The first laser was approved for LASIK eye surgery in 1998. Therefore, the long-term safety and effectiveness of LASIK surgery is not known.

FDA risks:

As with any surgical procedure there are risks associated with CustomVue^TM treatments. It is important to discuss these risks with your doctor before you make the decision to have the surgery. If the results of the surgery are not satisfactory, you may need to have additional laser treatment in the same eye. Your doctor may perform CustomVue LASIK for both eyes. However, sometimes it is better to have this procedure done on only one eye. Talk with your doctor about whether it would be better to treat one or both of your eyes.

Some risks are related to the creation of the corneal flap. Corneal flap complications include but are not limited to: cutting an incomplete, irregular flap or free flap; misalignment of the flap; and perforation of the cornea. Corneal flap complications range in severity from those that simply require the treatment to be postponed for several months, to those which create corneal irregularities resulting in permanently blurred vision.

You may need reading glasses after laser surgery even if you did not wear them before. Your vision may not be perfect, and you may need to wear glasses or contact lenses for some activities even after laser vision correction.

Contraindications:

If you have any of the following situations or conditions you should not have LASIK because the risk is greater than the benefit:

• You are pregnant or nursing, because these conditions may cause temporary and unpredictable changes in your cornea, and a LASIK treatment may improperly change the shape of your cornea.
• You have collagen vascular disease (e.g., rheumatoid arthritis), autoimmune disease (e.g., lupus), or immunodeficiency disease (e.g., AIDS), because these conditions affect the body's ability to heal.
• You show signs of keratoconus or any other condition that causes a thinning of your cornea. This condition can lead to serious corneal problems during and after LASIK surgery. It may result in need for additional surgery and may result in poor vision after LASIK.
• You are taking medications with ocular side effects, e.g., isotretinoin (Accutane^®*) for acne treatment or amiodarone hydrochloride (Cordarone^®) for normalizing heart rhythm, because they may affect the accuracy of the LASIK treatment or the way your cornea heals after LASIK. This may result in poor vision after LASIK.
• Your corneas are thin. If your corneas are too thin to allow your doctor to cut a proper flap in the LASIK procedure, you can't have LASIK because it is necessary to have a flap.