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Which Laser is Best? |
The LASIK Suite |
CustomCorrection |
Results |
Complications |
Before LASIK |
After LASIK |
Two methods are used to form a LASIK flap: microkeratome (MK) or femtosecond laser
(FL, Intralase™). The goals of flap formation are a smooth bed, consistent flap thickness, and safety with no damage to the flap. Both methods 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 even with the most recent FL upgrades.
The manuafacturer and some LASIK surgeons tout the FL, claiming improved results with lower complications. But there is no convincing evidence of this.
Numerous studies have compared the MK with FL, some show better results with MK, others with FL. However, these studies do not control for flap thickness since until recently MK flaps were 120 to 160 um and FL flaps are 100 um to 120 um. Recent evidence suggests that thinner flaps result in better visual performance. Dr. Roholt realized this several years ago and consistently achieves 100 um MK flaps with low standard deviation and low complication rate. He prefers the MK flap to the FL flap, which forms an incomplete cut and has to be dissected from the bed. The MK flap has rapid visual recovery, superior bed sommthness, and less flap inflammation compared to the FL flap.
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Before LASIK 
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