Femtosecond laser provides option of thinner LASIK flaps

Richard J. Duffey, MD

Refractive surgeon in the Premier Medical Eye Group, Mobile, AL.

There has been a recent trend toward thinner flaps for LASIK to decrease the risk of corneal ectasia following surgery. Other advantages exist as well for patients undergoing thin-flap LASIK.

The IntraLase femtosecond (FS) laser was introduced in the United States byPulsion (now IntraLase) approximately 4 years ago after receiving FDA approval. The push toward "bladeless" LASIK has been slow but has gained some ground swell over the past year. Professional surveys of refractive surgeons in the United States, done by the American Society of Cataract and Refractive Surgery (ASCRS) and the ISRS/AAO, suggest that IntraLase market share was somewhere from 3% to 8% in late 2003 and growing.1,2

Standard deviation and range were less with the MMK, suggesting perhaps slightly better predictability of flap thickness with a blade cut versus a laser cut when comparing these two specific systems. However, I suspect that setting the FS laser to a thinner flap setting and cutting a flap at an average thickness closer to 110 µm would have yielded a lesser standard deviation and range comparable with that of the MMK.

The key here, however, is the thin flap. Thin flaps exhibit less standard deviation than thick flaps, whether they are cut with an MMK or a FS laser.