Two recent independent surveys suggest a continuing trend among U.S. refractive surgeons toward using femtosecond lasers rather than microkeratomes to create the corneal flap in LASIK surgery.
The surveys were conducted separately by the American Society of Cataract and Refractive Surgery (ASCRS) and the International Society of Refractive Surgery of the American Academy of Ophthalmology (ISRS/AAO).
Femtosecond laser use: ASCRS survey
In the recent (2008) ASCRS survey, 33 percent of the respondents said they prefer using an IntraLase femtosecond laser to a microkeratome for creating LASIK flaps. Another one percent said they prefer using a Ziemer Femto LDV femtosecond laser.
By comparison, the 2003 ASCRS survey found that only one percent of surgeons responding preferred performing all-laser LASIK with a femtosecond laser to create the corneal flap.
Femtosecond laser use: ISRS/AAO survey
In the 2008 ISRS/AAO survey, 40 percent of surgeons responding said they preferred using an IntraLase laser to a microkeratome. In 2003, only eight percent of respondents said they preferred using a femtosecond laser.
Reasons for increased use of femtosecond lasers
Experts say this trend toward greater use of femtosecond lasers in LASIK surgery is due in part to consumer demand for blade-free, all-laser LASIK.
In response to consumer demand for all-laser LASIK, LCA-Vision, owner of 75 LasikPlus Vision Centers in 34 states and 60 markets in the U.S., recently announced it will offer exclusively all-laser LASIK in its surgery centers.
Experts also cite a growing body of evidence that femtosecond lasers are more predictable than microkeratomes and may produce fewer negative outcomes, such as dry eye, after LASIK surgery.
Microkeratomes: Still preferred by many surgeons
Many surgeons, however, still prefer using a microkeratome to create LASIK flaps.
They point out that today’s modern microkeratomes are more predictable and can accurately cut thinner flaps than previous models. Flap creation also is quicker with a microkeratome, which may reduce patient anxiety during the procedure.
LASIK cost is another issue. Because microkeratomes are significantly less expensive than femtosecond lasers, surgeons can charge a lower fee for LASIK with a blade-cut flap.
More femtosecond laser choices for surgeons
Another indicator of the growing popularity of all-laser LASIK is the increased number of femtosecond lasers available to U.S. refractive surgeons.
For years, the only FDA-approved femtosecond lasers were made by IntraLase (now owned by Abbott Medical Optics). Today, alternative femtosecond lasers available to LASIK surgeons in the U.S. include the VisuMax (Carl Zeiss Meditec), the Femtec (Technolas) and the Femto LDV (Ziemer).
SOURCE: Femtosecond laser use in US increasing, but some still prefer microkeratomes. Ocular Surgery News. June 2009.
Tags: femtosecond lasers, IntraLase