Laser Technology for LASIK
Reviewed by Leslie Doctor, M.D.M
Patients often get consumed by trying to decide what kind of laser technology they should have for LASIK. Your decision to have LASIK can be made even more difficult if you are asked to make a decision about what kind of laser technology should be used for your LASIK procedure.
The decision to have LASIK Surgery can be somewhat complex and difficult for patients. That decision involves not only deciding to have the LASIK Eye Surgery procedure but also the selection of a LASIK Surgeon who appears to be skilled and experienced, and with whom you are able to establish a level of trust. Yet a number of LASIK chains and even some LASIK practices promote and tout specific brands of lasers and different types of laser technology as a way of supposedly offering the patient a “superior” or “safer” or “more advanced” procedure. And-YOU-the patients are supposed to be able to make an informed decision as to the “best” technology. You have an obligation to be knowledgeable-but it is simply impossible for you to be able to sort through claims and representations of what makes “superior” laser eye surgery technology. You should understand the following:
You should NEVER even consider being treated on a laser that is NOT approved by the Food and Drug Administration (FDA). Unless your LASIK Surgeon is part of an FDA Clinical Trial, and has asked you to participate in that research, there is no reason whatsoever for an eye surgeon to be using an unapproved laser today.
If you were to take the time to review and study each and every FDA approval letter, you would find that while there are slight variations in clinical results, by and large the results of the clinical trials used to support the FDA approval are really quite good-otherwise the laser would not have been granted approval. The slight variations in clinical results are often the result of differences in patient selection for the FDA Clinical Trial, differences in the distribution of prescriptions of those patients enrolled in the FDA Clinical Trials and the slight difference in patient healing responses to the actual LASIK procedure. Certainly there are lasers that may be prone to a little overcorrection or a little undercorrection based on the data. However, this is where the real decision needs to be made-slight variations in laser technology are understood, measured and compensated for by skilled LASIK Surgeons.
THE KEY TO A SUCCESSFUL LASIK SURGERY IS THE SURGEON NOT THE LASER TECHNOLOGY
An experienced LASIK Surgeon will generally deliver safe, effective and predictable results with his or her laser-regardless of the laser type, as long as they have had a chance to do the proper diagnostic testing and taken the time to help you establish realistic goals and expectations.
A more important consideration in the selection of laser technology for your surgery is regarding the basic technology, not the brand of laser. Today, the best results are achieved with those lasers capable of delivering “small spot scanning” and "tracking". Each laser brand may have different "bells and whistles" that are touted, but if they are in fact scanning tracking lasers, you can be comfortable that your treatment is being performed with current technology and the results delivered will be more dependent on the surgeon and your suitability than the laser technology. If your LASIK Surgeon is not using a scanning and tracking excimer laser system, you need to know why!
Another important consideration is whether the laser system being used for your treatment is regularly serviced and maintained by the manufacturer. While it might seem obvious that a high performance medical device such as an excimer laser should have routine preventative service, doing so is extremely costly and so there are in fact centers and surgeons who skip the preventative service and just have it repaired when it fails to function. This is not a good clinical practice and yet some "cost cutters" actually do this. Rather than being concerned about the brand of laser, make sure the laser you are being treated on is regularly maintained and certified by the manufacturer rather than on an "as needed" basis.
To summarize regarding LASIK laser technology:
- The LASIK Surgeon, not the laser makes the difference.
- Any differences in clinical results between brands of lasers are subtle.
- Only be treated on a small spot scanning tracking laser that has been regularly and preventatively maintained.
- If your LASIK Surgeon has done a thorough examination and consultation, and deemed you a suitable candidate, trust them to select a laser they are comfortable with to perform your treatment-it is not your decision!