LASIK 101: Making the Flap Procedure in San Diego
Dr. Motwani uses two different methods and devices for making the flap. The first is the Alcon WaveLight FS200 femtosecond laser, part of the WaveLight Refractive Suite. This is a highly advanced, and rapid flap making laser that is designed to make highly customizable, reliable thickness flaps.
The Refractive Suite has a bed that moves the patient in between the FS200 and the EX500 laser which does the refractive correction. The patient never has to move from the bed during the procedure. The FS200 is able to easily customize the flap for not only thickness but energy used, so it can make a flap with the least amount of energy needed thereby decreasing inflammation and speeding visual recovery.
The FS200 is extremely fast, making a flap in about 6 seconds, far faster than the Ziemer Femtosecond laser (which takes about 30-60 seconds) and the AMO Intralase IFS femtosecond laser. The FS200 has an automated suction system, unlike the IFS Intralase laser which uses a manual syringe (!). The FS200 has both video and microscope capabilities, allowing a surgeon full control over flap creation and visualizing it constantly unlike the Intralase which uses only video, and the Ziemer, which cannot visualize the flap creation while it is working.
Controls on the FS200 are much more advanced and information in planning the procedure is much more thoroughly presented on the FS200 to minimize errors in use. Surgical planning for the flap can be performed on the same Wavenet planning laptop stations that the Contoura planning is done on, so the surgeon can program the settings for the laser reshaping and the laser flap at the same time, and the information is linked through the Wavenet server for both procedures thereby customizing it for each patient, each procedure, and minimizing mistakes.
Dr. Motwani is certified on and has also used 2 different Ziemer Femtosecond lasers, and is certified on and has used the AMO Intralase IFS Femtosecond laser. His comparisons are from personal experience, and he strongly feels the FS200 is by far and away the most technologically advanced femtosecond laser he has ever used. It is in a completely different category than the Intralase IFS, which to Dr. Motwani feels is completely antiquated, while the Ziemer is still an excellent femtosecond device, but just slower than the FS200.
The second device used by Dr. Motwani is the Moria M2 Evolution System. This was the pinnacle of development of the blade microkeratome. A special source of blades that Dr. Motwani helped to develop is used to ensure reliable safe, reliable thickness flaps. Because the system only takes 1.5 seconds to make the flap, the entire procedure is done in under 10 seconds. Because no energy is put into the flap, the healing time is faster, with visual recovery usually starting almost immediately. At Motwani Lasik Institute we want our patients to be fully informed. Although making reliable thickness flaps is important, how a flap is made makes no difference on the visual correction and how someone will ultimately see. The best laser devices minimize the laser energy to decrease swelling and allow for fast visual rehab. The Alcon WaveLight FS200 is without question one of the most sophisticated lasers in the world, and has wonderful results, but it still only makes a flap. It does not perform the laser re-shaping which is what really matters in laser vision correction.
The Moria system is also the device that can be used to an epithelial only flap for the procedure called Epi-LASIK. This is a highly advanced procedure only performed by a few surgeons in the United States that is utilized by Dr. Motwani for large corrections that do not have enough corneal tissue available to perform LASIK, and are too large a correction for PRK or LASEK.
Unfortunately, one of the most confusing marketing tactics that Lasik centers use is the description of how the flap is made. Somehow this becomes the focus of the Lasik procedure, when in reality how a flap is made has absolutely no impact on the visual outcome of the Lasik procedure. The most important aspect of making a flap is reliable flap thickness, which is important for safety. Otherwise, a flap is a flap is a flap as long as a device makes a consistent thickness flap.
Feel free to discuss during your consultation the merits of both ways of making the flap, or just let Dr. Motwani recommend which device is right for your particular case.