Dr. Schwartz shares how laser eye procedures differ and in what ways.
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The Types of Laser Eye Surgeries Differ All LASIK eye procedures are not the same. In fact, in the early days of LASIK there were very few options. There were maybe one or two lasers; they all operated on very similar principles. There wasn’t a lot of technological advancement from one to the other. So, you know, wherever you went, as surgeons in the early, early days nobody had a lot of experience so it didn’t really make a lot of difference because everybody’s equipment was similar and everybody’s surgical level was pretty much around the same. Now things have really changed, they have evolved. There are places that have still held on to this 10-year-old, 12-year-old equipment and the reason behind it, I have to think it, is it’s paid for and they can charge less and that’s a business model, you know, and some people choose to do that. The business model I’ve gone after and tried to do is I have the most modern technology and I try to stay as current as possible. You know, in that regard, there’s a way the flap can be made. There are people who are still using blades. I don’t use blades anymore. There are five generations of IntraLase in use in the world. In all of Arizona there’s one fifth generation IntraLase – that’s the one I have. There are some places that have four; there’s some that still have as low as second generation IntraLase being used. You know, when the patient goes, a consumer goes to check and say, “Well, oh you’re doing it all laser, well that sounds like it’s the same.” Well it is, it’s better than a blade, but the difference between fourth and fifth generation, fifth generation heals about 10 to 20% stronger after it heals. It’s the design of the flap architecture, just the way the edge is tapered. The bed underneath where the lasering is being done to shape the eye is smoother. That increases the quality of the vision. The translation time, the time it takes for the flap to be created is anywhere from a half to a third the time, so it’s much more comfortable for the patient. It’s got better quality vision. It heals stronger. It’s a better generation and that’s why I have it. That’s just creating the flap. Now you have a look at the laser, it’s going to actually shape the eye and give you the correction that you are looking for. Well, when you correct the eye using a custom wave of laser, which is what I have -- I have the one with iris registration from VISX. It’s their most advanced CustomVue. What happens there, it takes an image of your eye prior to the procedure, takes another image of your eye during the process and that lines them up. When a regular laser treats you and you lie down on the table your eye is going to cyclotort. It’s going to turn anywhere from two to ten degrees. With a standard laser or a laser that doesn’t have iris registration is going to treat right next to all these little finer perfections we are trying to fix. What iris registration does is it rotates the treatment to match your eye so that it lines up perfectly. That decreases the risk of having night time halo, glare, and starbursting.

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