Most people believe all LASIK procedures use 100% lasers. Not True. Dr. Jon Dishler is the First and Most Experienced IntraLASIK surgeon in Colorado. . . . Though most Lasik procedures are customized, based on the degree of refractive error (a measure of how well your eye processes light), Lasik was given a booster shot a few years ago with the approval of technology called Wavefront. That allows doctors to make a more detailed map of the eye, reshaping the cornea to more exact specifications. Despite Lasik's high-tech approach, the majority of doctors use a handheld blade called the microkeratome to make the corneal flap, the first step of the procedure. But now some doctors are using a newly approved laser technology called IntraLase, which can improve contrast sensitivity and produce superior vision. More than 400,000 laser-guided flap procedures have been performed in the last three years--75,000 of which were done in the first three months of this year alone. The laser is a bit more expensive than a traditional approach, adding about $300 to an $1,800-per-eye Lasik price tag. But results from a 200-person U.S. Navy study shows that military personnel who underwent Lasik with laser-guided corneal flaps had a quicker visual recovery, better contrast sensitivity and visual acuity--even at night--compared to those who underwent the more traditional handheld microkeratome approach. "There was a lot of healthy skepticism in the field as to whether this approach would pan out," says Dr. Steve Schallhorn, director of cornea services at Naval Medical Center in San Diego. "I'm not here to blow smoke or paint too rosy a picture, but overall we're pretty happy." - Newsweek: Beyond Lasik; 07/2005 (full story here)

Is IntraLase right for you? Patient information brochure How IntraLase works IntraLase FAQ's

IntraLASIK: Creating a LASIK Flap With Precision

A new laser is making LASIK even safer. Surgeons are using the IntralaseTM laser to create a corneal flap under which they reshape your eye to correct your vision. In traditional LASIK, surgeons use a blade called a microkertome to create the flap. Although surgical complications are rare during LASIK, the microkeratome portion of the procedure is often the source of the problem. The Intralase laser is the only FDA approved laser designed for the creation of precise corneal flaps. This new femtosecond technology provides the only ALL Laser SolutionTM for the creation of corneal flaps needed for the crucial Step One of the LASIK procedure. (Click here to learn more).

Since April 2001, Jon G. Dishler M.D. has been using the IntraLase Pulsion FS laser. In fact, he was the first surgeon in Colorado and the third doctor in the country to introduce IntraLASIK, and as an investigator helped to perfect its design. Since then, over 7000 eyes have been treated using the Intralase at the Dishler Laser Institute. Dishler Laser Institute had the choice of staying with the old blade technology or investing thousands of dollars in the newest technology. We wanted the best for our patients, so we chose Intralase. In fact, as of Fall 2004, Dishler Laser Institute no longer offered the traditional mechanical microkeratome using a surgical blade for laser vision correction except in special cases. This all laser approach, offers Dr. Dishler a computer controlled, minimally invasive technique that reliably creates precise corneal flaps that is not attainable with the mechanical blade technology.

How It Works

The Pulsion FS Laser uses infrared light to precisely cut tissue by a process called photodisruption. The laser beam is focused, via optics, into a tiny 3-micron spot that passes harmlessly through the outer layers of the cornea until it reaches its exact focal point within the stroma (central layer of the cornea). When it reaches this focal point, the beam forms a microscopic cavitation bubble of carbon dioxide and water vapor. By making an interconnecting series of these bubbles in a tightly wound, "inside-out" spiral, a dissection plane is created at a precisely controlled depth within the corneal stroma. The laser accomplishes this dissection with considerably more precision and accuracy than is possible with a microkeratome or other steel-bladed surgical instruments. The laser beam then stacks a pattern of bubbles along the periphery of the dissection plane, leaving an uncut section of tissue to act as a hinge. This final dissection to the surface is beveled; meaning the outer diameter of the flap is slightly wider than the inner diameter. This unique shape assists in realignment and seating of the flap upon completion of the excimer treatment.

Because the low energy pulse from the Pulsion FS Laser is in the femtosecond range-a mere quadrillionth of a second- there is no heat damage to surrounding tissue. With no transmission of shock waves to surrounding tissue, the femtosecond laser is less invasive than the mechanical microkeratome, and well suited for delicate corneal surgery.

I have performed thousands of successful LASIK surgeries using a microkeratome but IntraLASIK has increased the precision of the crucial flap step of the LASIK procedure. It also is more comfortable for my patients who appreciate the added safety of this advanced technology. - Jon G. Dishler M.D.

Comparing IntraLASIK and Lasik: The Corneal Flap is the Difference

People not eligible for LASIK may be able to have IntraLASIK.
It is widely recognized among refractive surgeons that one of the most important aspects of LASIK surgery is consistent flap thickness. Most people have corneas between 500 to 600 microns thick. Most keratomes cut flaps between 100 and 200 microns thick. The problem is that, it is difficult to know how thick a microkeratome flap will in fact be until it is actually cut. For people with thin corneas, LASIK surgeons must be cautious to balance the thickness of the cornea against the amount of vision correction needed and may even decide the procedure in not advisable.

The Intralase laser eliminates most of the uncertainty in flap creation because it is computer controlled. As a result, flaps can be made that are both accurate and consistent in thickness and diameter. With IntraLASIK, an accurate corneal flap as thin as 100 microns can be created which may allow surgeons to confidently perform IntraLASIK in people with thinner corneas. This is even more important in patients with higher corrections or large pupils.