Microkeratome versus Femtosecond Laser
Two methods are used to form a LASIK flap: 1) microkeratome (MK) or 2) femtosecond laser (FL: Intralase™ , FemtoLDV ™ (DaVinci). The LASIK procedure performed with a femtosecond laser is sometimes called "All-Laser LASIK" or "Bladeless LASIK."
The goals of flap formation are a smooth bed, consistent flap thickness, flap hinge away from the treatment area, and safety with no damage to the flap. Both methods can accomplish this. Current MK's are 5th generation devices and are extremely safe compared to the earlier instruments. The MK creates the smoothest bed, but requires more surgeon experience than the FL. The FL flap creates a more uniform flap thickness, but is slower than MK with more tissue adhesion.
Studies show that results using the FL flap are at least comparable to those obtained with the MK, with a lower complication rate. However, no procedure is complication free, and flap complications can occur whether created with the laser or MK.
Numerous studies have compared the MK with FL, some show better results with MK, other with FL. However, these studies do not always control for flap thickness since until recently MK flaps were 120 to 160 um and FL flaps are 100 um to 120 um. New evidence suggests that thinner flaps result in better visual performance for patients. Dr. Roholt realized this several years ago and consistently achieves 100 um MK flaps. while the MK flap has rapid visual recovery, superior bed smoothness, and less interface inflammation, the FL is better for patiens with anatomically small orbits, flatter corneas, or anxiety.
At Roholt Vision Institute, the FemtoLDV (DaVinci) is used for Bladeless, All-Laser LASIK. This second-generation, solid-state laser produces a more focused, faster treatment than the Intralase™ .
For more information regarding the FemtoLDV visit: www.ziemergroup.com/home/products/ldv.html
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