Intralase

[Dotanne]

My Lasik surgeon and his associates are advertising Intralase as being less likely to cause dry eye. Has anyone here got dry eye or other problems from Intralase? I think I have read somewhere that it may cause more GASH and poor night vision. Can anyone come up with the disadvantages of Intralase? I always spread a negative message about Lasik surgery but now it is Intralase (for chickens they say in the ad!!!!) I would like to be able to say that there can be problems there too.
Dotanne

[YGB]

I had Intralase LASIK and as you know, I have had major problems including severe dry eye. I believe the main difference between the "old" LASIK and Intralase is that with the "old" LASIK, they used a microkeratone blade to cut the flap/cut the wires. With Intralase, they now use an Inralase laser to do the same thing (i.e. cut the flap/wires). The bottom line is that all they have done is changed the method for cutting the flap/wires. For people that were afraid of a blade slicing their eye, now they supposedly should have no fear because a laser will slice it instead. Of course, the nerves are still fried (possibly even more so) with the laser. The technological "upgrades" that they have come up with for LASIK is a bunch of $%#*. The "upgrades" still damage every eye that they slice/laser and the MD still has very little plan B to fix complications. Also, complications are very likely under-reported.

I have found that the best way to convince people not to have LASIK is to tell them about how much it costs once you have complications for things like drops, goggles, MD visits, etc.. I initially thought that just telling people of the risks would be enough. However, I found that the marketing for LASIK is so entrenched in our society and most people have such little concept of eye pain and damage, that just telling people of the possible risk of eye damage does not seem to be enough. It's only when post-operative complication $'s come into play, that I notice some people really start rlistening. Pretty strange observation, but that is par for the course in this very strange LASIK world.

[Rebecca Petris]

In my opinion, Intralase clearly represents a substantial technological improvement over microkeratomes when it comes to reducing flap-related complications, including very serious conditions such as corneal ectasia. Intralase creates a thinner flap and - crucially - a flap of more reliable thickness in relation to the programmed thickness. This is well documented, and it's an important benefit when it comes to overall safety. I chatted with surgeons about this at ASCRS - surgeons that use microkeratomes - and they acknowledged that Intralase is the better technology, and that the only reason they don't use it is because the machine costs a fortune.

Mind, I'm not an Intralase cheerleader. I don't like flaps no matter what they cut them with. Furthermore I haven't seen data or heard overwhelming anecdotal evidence that convinces me that Intralase creates less dry eye than microkeratomes. I'm surprised anyone would advertise that, and I'd sure like to see the studies they read that they are using to back up that claim (if any).

[Rebecca Petris]

Furthermore I haven't seen data or heard overwhelming anecdotal evidence that convinces me that Intralase creates less dry eye than microkeratomes.

Hm. Okay, I eat my words. I haven't looked at this in depth but having poked around I see there are several studies being quoted as showing less dry eye with intralase. How good they are, I dunno. There's an awful lot of clinics out there claiming that intralase is making dry eye a thing of the past, which is obviously not true. I would never have guessed based on the patient experiences reported here and on D'Eyealogues that there's any difference.

Sorry Dotanne, I'm not really posting anything that serves your purpose here.

My personal attitude about laser surgery is something like this:

No surgery is far better than surface ablation which is substantially better than intralase which is somewhat better than traditional lasik. If you can't talk 'em out of it, talk 'em into getting the safest form of it for their specific case.

[sazy123]

IMO they are still slicing the nerves which causes dry eye and will cause chronic dry eye espicially if there is already underlying dry eye. Changing the method is not stoping the problem 'slicing nerves'.

[YGB]

Another point is that while people do not trust MD's as much as they did 30 or 40 years ago, there is still a sense that when you see an MD, he/she is not going to do anything to make your healthy eyes pre-MD visit/LASIK become damaged eyes post-MD visit/LASIK.

With LASIK, that is exactly what the MD does on every patient!!! For some patients, it is temporary (although just because they do not have symptoms in the first few weeks/months/years post-LASIK, they may have signs). For others, they also have symptoms in addition to signs and the damage including debilitating symptoms can for some be permanent.

The bottom line is that the LASIK MD damages the patients eyes (IMO, in violation of his/her Hippocratic Oath) and then hopes that the eyes heal. If the eyes do not heal from the LASIK damage (ex. severing nerves), the patient is up the creek typically without an MD who has a clue on how to help.

Note that my own LASIK MD stated to me during one of my visits that he sees post-LASIK patient's whose eyes look much worse than mine and when he asks them how they feel, they say "fine". The MD then said he responds with "great".

Basically, the LASIK MD was telling me that if the patient is not complaining, then the MD sees no reason to notify the patient that he/she has clinical signs of eye problems (ex. dry eye) post-LASIK.

Obviously, this whole LASIK experience has ruined my faith in the eye profession. The LASIK MD's are the biggest problem, but the non-LASIK MD's who see the damage, but view it as their peers problem and not their professions issue are also largely at fault. As one non-LASIK MD told me "jokingly" after I had already been damaged ... "there's a reason why I am still wearing glasses" (i.e. LASIK is not good for your eyes).

Gee, how sad that many eye MD's are so knowledgeable about the damage of LASIK, but yet there is radio silence amongst so many of them (virtually all?) about the damage being done.

[bostonlover]

I paid the extra to have intralase because I was concerned about dry eye post lasik and was told it was better. I am coming up on my one year anniversary and still suffer anywhere from mildly to severly depending on the day/week.

[Lucy]

BostonLover

I am coming up on my one year anniversary and still suffer anywhere from mildly to severly depending on the day/week.

I'll bet your doc says your eyes look "great." My eyes can hurt so bad I can't keep my eyes open, but the doc always says "they look fine." I wish he saw what I did.

Lucy

[Guest]

I'll bet your doc says your eyes look "great."
Lucy

Just reply with "try lookiing at them from this side and I'm sure you'll agree that they are not as good as they look".

Or you could try "let's swap for a week or two and see if you still maintain the same professional opinion."

A bit of sarcasm goes a long way sometimes.

Ian

[bostonlover]

I actually abandoned the "care" of my lasik clinic long ago. I only ever was offered to be seen by a pompous jerk of an optometrist who said exactly what Lucy just said. I would leave in tears after every visit. So, I was referred to an opthamologist by my primary care physician when I was about 6 months post lasik. She has been great in that she does actually listen to my symptoms and has been willing to go with whatever treatments I presented to her so far.

[Guest]

Dotanne,

My laser clinic in the UK are calling this procedure "Intralase Femtosecond Laser LASIK".

A brief description from the site suggests that a laser is used to make the corneal flap without the need for a mechanical microkeratome - the flap is more precise, accurate and thinner resulting in many benefits to the LASIK patient. The description makes it sound like a lovely picnic in the park - NOT!!!

You can even go the whole hog and have Femtosecond with wavefront - the thought of it makes me sick in the pit of my stomach.

There is a reference to http://intralasefacts.com/ should you be interested in reading the neauseating facts for yourself - but beware the site is predominately self promotion of the procedure and of course a comprehensive list of surgeons (most of whom probably wear glasses ) willing to perform the procedure for you.

Just to provide a little balance to this post there is no mention of any complications of the procedure on either site (my clinic or above site) and more importantly, there is no mention that dry eyes could result - no surprises there then!!!!

Good to see that informed consent is alive and well!!!!!!

Ian

PS
Further to my tongue in cheek post, I noticed the testimonials on the above site are all from Dr's most likely earning a living from the procedure, there is not a patient in sight - the LASIK snowjob continues with a vengeance......

[Donnabod]

Refractive surgery shock syndrome

Just to go a little off the thread l wondered if anyone else had looked up this syndrome. As l am feeling particularly down today due to my very very laski enduced dry eyes, l searched the internet to see if l could find out any info about my symptoms. This is what l found and it perfectly describes what l am feeling. So if this can be helpful to all the newcomers on site take a look, it is reassuring to know that you are not going mad but are dealing with something traumatic. Maybe they can add this to their list of complications.!

Donna

[Rebecca Petris]

Here is a link to a presentation about the RSSS Donna mentioned.

[indrep]

My exprience shows that most Intralase surgeons are aggressive in treating possible dry eyes before surgery. Many practices plug 100% of the patients prior to surgery. Many patients are started on nutriceuticals 4-6 weeks before surgery. So it is possible that these surgeons are reporting less dry eye complications post op.