Another day, another upgrade! We have now upgraded the laser that we use for vision correction to the new Schwind Amaris. Our previously laser was the Bausch & Lomb Zyoptics which served us well for many years.
The Intralase, which is a femtosecond laser that creates the Lasik flap has also been upgraded to the latest generation machine which means that the flap creation is now much faster.
The new Schwind is the laser that actually performs the refractive correction.
So what is soo good about the new laser? Well amongst other things, it is capable of performing a transepithelial PRK which the B&L machine could not do.
How is PRK different to LASIK?
PRK has had a resurgence in recent years as LASIK surgeons realised that not all patients were suitable for LASIK yet many could still be helped with PRK. PRK of course became unpopular because of its slow visual recovery and postoperative pain. It is no surprise that when LASIK came along with no pain and virtually instant recovery that it quickly became the default leaving PRK behind. PRK however has its advantages in that the absence of the LASIK flap means an instant saving of 120 microns of cornea that does not contribute anything to the structural integrity of the cornea. This means that anyone who has a thin cornea may not be able to have LASIK but may well be able to have PRK. The goal is to leave enough cornea after the vision correction to minimise any future problems such as ectasia. In addition, there are a number of potential flap related complications that clearly do not apply with PRK.
How does the new laser remove the epithelium? Transepithelial PRK
Traditionally, the epithelium is removed prior to laser either by alcohol of by manually scrapping it of. Some surgeons use a motorised brush.
With the new transepithelial laser however this is no longer required. The epithelium is now automatically removed by the laser.
The way that the laser performs this is by using an algorithm that determines how thick the epithelium is that is required to be removed.
The result is a much neater epithelial removal without the increased risk of recurrent erosions which are associated with alcohol removal.
Curiously, we have observed that the pattern of pain following the procedure is also different. It is not less, but most would complain of discomfort mainly on the second day after the procedure whereas now the peak comes a day earlier. It still however seems to last about 2.5 days.
Visual recovery seems no different.
The new Intralse
The femtosecond laser which is used to create the LASIK flap has also just been upgraded to the latest model. This new laser runs at a higher frequency which means that it is able to complete the flap much faster which in turn means that problems such as loss of suction are less likely to occur.