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IntraLase improved refractive outcomes of LASIK

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ROME — The IntraLase femtosecond laser flapmaker improves the outcomes of LASIK, producing better quality flaps with fewer flap-related complications, according to several surgeons speaking here at the winter meeting of the European Society of Cataract and Refractive Surgeons.

Jonathan H. Talamo, MD, compared a large cohort of 1,122 patients who underwent LASIK with a mechanical microkeratome with 1,240 cases in which the IntraLase FS laser was used to make the flap.

“With femtosecond laser cuts, there is no risk of buttonholes or free caps,” Dr. Talamo said. “Epithelial defects and ingrowth are far less frequent.”

The increased incidence of diffuse lamellar keratitis (DLK) that has been reported in some studies is, in his opinion, “only associated with the learning curve of the procedure, due to incorrect energy setting and excessive flap manipulation,” Dr. Talamo said. Once surgeons become familiar with the new technique, the DLK rate is comparable to, if not less than, the rate in standard LASIK, he said.

Visual outcomes, he added, are better with the IntraLase because “flap thickness is more predictable and consistent, flap shape is more uniform, flaps can be larger, with a better hinge and significantly less astigmatism,” he said.

“Quality of vision is also improved, and there are fewer induced aberrations. Limitations of the technique, at present, are the higher cost, the slightly longer surgical time and the so-called transient light sensitivity syndrome, reported by some of the patients,” Dr. Talamo said.

Similar opinions on the device were related by Lucio Buratto, MD.

“Flaps are incomparably better, perfectly round and with smoother surfaces. Flap uniformity can be seen with pachymetry and corneal topography, and the Artemis system shows minimal variability in central thickness across different flaps and minimal regional variability within the same flap,” Dr. Buratto said.

IntraLase, Dr. Buratto said, improves safety, accuracy and quality of vision, improves results with customized ablation, improves patient satisfaction, and is likely to increase the number of patients interested in LASIK surgery.

A study performed with confocal microscopy at the Vissum Institute of Alicante also confirmed the “superior quality” of the femtosecond laser flaps, according to presenter Jaime Javaloy, MD.