Find solution
Is there a benefit to having a double major?

Why are there so many options in laser eye surgery, do they add any real benefit or are they simply snake oil?

  • After reading though the treatment options provided by a well-known UK laser eye surgery, it seems to me that some of them may be... optional. I understand that they're options that one can choose to take, but I mean optional in the same way as paying another 10% on top of the price of a car for metallic paint or tinted windows - potentially unnecessary luxury items, "badges". I'm wondering whether there's any real added benefit of taking the options.For instance, one option is "Wavefront" where the thickness of the cornea is judged prior to reshaping to create a more consistent thickness. If this is a better way to reshape the cornea, why isn't it the *standard* way to reshape the cornea? I'm concerned that it's just a way to double the price of treatment for no particular reason.Another option is "IntraLase" where a laser is used to "[create] the protective flap at the beginning of LASIK treatment." Which sounds like a major benefit, but reading the documentation it would seem that the laser just creates a "guide" and the flap is still created with a blade. So is it worth it? Especially for an additional 30% per eye (on top of the Wavefront price)?

  • Answer:

    When counseling patients I tell them to think of a standard LASIK treatment as taking the glasses prescription and putting it into the laser to guide the corneal shaping. Wavefront guided treatments use the eyeglasses prescription as well as other factors in the visual system which may be causing blur, called higher order aberrations, to reshape the cornea. While in fact most patients do just fine with the standard LASIK treatment, the wave front may offer an advantage in patients with large pupils, as well as in low light or contrast situations. Intralase does not use a blade to make the corneal flap. The flap is created with a very high frequency laser. The major advantages of a laser flap are its uniformity as well as improved safety profile. However in the hands of an experienced surgeon either method should produce a good result. Wavefront treatments and Intralase flaps are certainly not snake oil. They represent technological improvements and thus are priced higher. Only you can decide if this is of value and that you are  willing to pay more for it.

Aaron Florkowski at Quora Visit the source

Was this solution helpful to you?

Other answers

There are so many options and fancy terms, I'm afraid, because of the degree of commercialization that has overtaken the refractive surgery industry. Every LASIK centre wants to tout itself as the best. As the one with all the latest technology, even if they do not really have it. But let's call a spade a spade, and hopefully the following answer can clear up some misconceptions.1. Is a femtosecond laser (several brands available-Intralase, FS200, Visumax, Ziemer) created flap worth it?A femtosecond laser helps to create a corneal flap-a very thin layer of corneal collagen tissue+epithelium that can be flipped open and then closed again after excimer laser recontouring of the underlying bed. The alternative? Using a special oscillating metal blade called a microkeratome.The femtosecond laser fires a series of spots in a very precise layer within the cornea. These act a bit like the perforations between postage stamps, allowing the surgeon to lift the flap with a blunt instrument (thereby making the surgery 'bladeless').In my opinion, this is much better than doing the flap with a metal blade.a) the dimensions of the flap are much more precise with the laser-both the diameter of the flap as the thickness. These parameters are crucial-especially flap thickness-since cutting a thicker flap inadvertently would make the cornea unnecessarily weaker.b) the shape of the flap edges can be configured (with the femtosecond laser) so that the flap and the adjacent corneal edge fit together like a mortise. This may help to reduce the risk of flap slippage. In my experience, such sharp edged flaps also have a much lower risk of a complication called 'epithelial ingrowth'.Metal blade created flaps inevitably have sloping edged flaps, and a higher incidence of epithelial ingrowth, especially if an enhancement is required.c) femtosecond laser procedures are safer-if anything happens with the laser in the middle of a cut, the procedure can be aborted with little consequence. With a metal blade, if it stops midway, or causes a buttonhole, well, what's done is done.2. What's 'Wavefront' and is it worth it?The term 'wavefront' was borne out of optics, especially by telescope lens designers trying to obtain the best possible images. Wavefront refers to a 'front' of light beams as they enter and pass through a lens. Ideally, they should be focused as per refractive requirements and not scattered or bent in undesirable ways. Unfortunately, all optical systems (including the cornea of the eye) have irregularities that cause 'wavefront aberrations'-which may degrade the resulting image depending on the type and degree of the aberration.So excimer laser engineers tried to measure the wavefront aberrations of the eye and tried to program the laser to treat these (higher order) aberrations, in addition to the usual long/shortsightedness/astigmatism. This is called an 'Ocular Wavefront Guided' treatment.Some systems measure wavefront aberrations of the cornea only-treatments based on this would be called a 'Corneal Wavefront Guided' treatment.The terms Wavefront-optimised, Aberration-Free and so on are not wavefront guided at all-these still only treat long/shortsightedness/astigmatism with some tweaks to the laser algorithm. iDesign and other similar terms further muddy the water and are just marketing brand names. If you get confused by a whole lot of terms, just ask-'will I be getting a wavefront guided treatment or not?' or 'do I need a wavefront guided treatment or not?'To cut a long story short-not everybody needs a wavefront guided treatment. Some people have naturally smooth, regular corneas and doing a wavefront guided treatment does not add any measurable benefit. While others with aberrated corneas would do much better if a wavefront guided treatment was done. In such patients, wavefront guided treatments, by helping to reduce aberrations, may provide a better quality of vision especially in darker conditions.To sum upGet LASIK with a femtosecond laser created flap if possible. And ask your LASIK doctor whether he thinks you really need a wavefront guided treatment.

Por Yong Ming

Related Q & A:

Just Added Q & A:

Find solution

For every problem there is a solution! Proved by Solucija.

  • Got an issue and looking for advice?

  • Ask Solucija to search every corner of the Web for help.

  • Get workable solutions and helpful tips in a moment.

Just ask Solucija about an issue you face and immediately get a list of ready solutions, answers and tips from other Internet users. We always provide the most suitable and complete answer to your question at the top, along with a few good alternatives below.