Advantages of Laser Flaps or Blade Flaps in LASIK - Dr. Boxer Wachler, what are the advantages of m... | Flap, Microkeratome, Much, Intralase, Flaps, Laser

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Advantages of Laser Flaps or Blade Flaps in LASIK

Dr. Boxer Wachler, what are the advantages of modern microkeratomes (blade) compared with IntraLase (laser) as LASIK flap makers?

Boxer Wachler: I'm for whatever is best for the patient, but I do use the microkeratome much more often than I do IntraLase. Microkeratomes make the procedure go so much faster and are much more comfortable for the patient. Suction in a microkeratome procedure lasts about three seconds, whereas suction using IntraLase lasts about 15-20 seconds at its fastest. Also, you use less suction on the eye with a microkeratome. I prefer patients to be as comfortable as possible, which is why I prefer the microkeratome.

Dr. Thompson, what are the advantages of IntraLase (laser) over microkeratomes (blade)?

Thompson: I use both, and I counsel patients about both.

But I like using the safest technology for the situation. When the FDA approved the laser flap maker (IntraLase in 1999), the blade or microkeratome flaps were the main source of my vision threatening complications in LASIK — whether they were free caps (unattached flaps), partial flaps, or buttonholes (improperly formed flaps) or an epithelial slough (damaged eye tissue). [See also: LASIK risks and complications.] I just found that, even though the vast majority of blade flap cases went well, when they didn't go well — it was ugly.

So I liked the idea of a laser flap maker. I don't have to worry about buttonholes, partial flaps, and free caps. It just brought so much more inner peace to an extremely important part of the procedure, which is creation of the flap. It also brought more inner peace to my staff. Our operating room days now are much nicer.

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