Most Advanced: Allegretto WaveLight EX500 Excimer Laser
Dr. Cohen’s first choice in excimer lasers is the Allegretto WaveLight EX500 Excimer Laser, which he uses in more than 90% of his New Jersey and New York LASIK cases. Dr. Cohen also uses the WaveLight FS200 Femtosecond laser in bladeless LASIK. These are the newest machines available.
He selected this laser technology because he considers it to be the leader of the pack. In Dr. Cohen’s expert hands, the Allegretto WaveLight EX500 Excimer Laser technology consistently achieves the best outcomes, improves patient comfort, and greatly reduces the need for enhancements.
Allegretto WaveLight EX500 Excimer Laser (built by the German company, Erlangen WaveLight GmbH, a subsidiary of Alcon in Fort Worth, TX) is the newest, fastest and most precise excimer laser system available in the world. It was approved by the FDA in 2006. Operating at 500Hz while applying 400 treatment pulses per second, the Allegretto WaveLight EX500 Excimer Laser makes it possible to perform accurate laser vision correction up to 10 times faster than other methods. It provides superior results, greater precision, and better safety.
When compared to other excimer lasers, the Allegretto WaveLight EX500 Excimer Laser:
- customizes every treatment to the patient’s individual prescription and cornea
- delivers precise work at high speed with PerfectPulse Technology™
- high speed means less stress and discomfort for patients
- follows the eye’s fastest movements with high-speed eye-tracker
- automatically adjusts to changes in pupil size during treatment
- achieves a rounder, more natural corneal surface than many other lasers
- virtually eliminates the glare and night vision problems associated with older generation lasers
- can achieve uncorrected visual acuity of 20/16 or better
- has a total re-treatment rate of less than 5% of patients
- ensures a maximum level of safety
Gold Standard: VISX® STAR S4 IR
This is the most commonly-used excimer laser machine in the USA (from Abbott Medical Optics, Inc., Santa Ana, CA). VISX is the American company that invented laser vision correction in 1986 and the company was later acquired by Abbott.
VISX® STAR S4 is 15-year-old technology that has undergone a series of upgrades in the last few years. (Think of it as upgrading the CPU, the memory and other features on your old desktop PC.) It delivers a broad range of wavefront-guided laser vision correction treatments to patients, but has limited success in treatment of astigmatism and may induce glare and halos when not in the “wavefront” mode (which cannot be used in all patients).
VISX® STAR S4 is Dr. Cohen’s laser of choice for patients with certain rare corneal conditions (e.g., PTK, or phototherapeutic keratectomy, for recurrent corneal erosion, etc.).
When compared to other excimer lasers, the VISX® STAR S4:
- removes about 20% less corneal tissue than some of its competitors
- tracks eye movement with ActiveTrak™, which helps ensure precise results
- requires no pupil dilation, which promotes speedy recovery and causes less discomfort
- produces an extremely consistent surface on the cornea after the procedure
- minimizes additional time required for custom wavefront-guided treatment compared to conventional treatment
Bladeless Flap Creation: Ziemer FEMTO LDV™ FS Laser
A femtosecond (FS) laser is the first step in the “all-laser” or “bladeless” Custom LASIK procedure and is used to shape and create the corneal flap for qualified patients. This eliminates the need for cutting a flap with the traditional mechanical microkeratome, a hand-operated blade instrument. After a flap has been created, treatment with the excimer laser (above) begins.
Dr. Ilan Cohen’s femtosecond laser of choice is the Ziemer FEMTO LDV™ (Ziemer Group, Port, Switzerland), which is the newest and most advanced FS laser approved by the FDA (2008). With a beam that is faster but less intense than conventional FS lasers, this innovative high-frequency technology allows more flexibility in flap cutting, improves safety to the highest level, and promotes faster healing and better patient comfort.
Dr. Cohen prefers the Ziemer FEMTO LDV™ for its tremendous level of control and unprecedented precision, and believes that the laser’s advantages lead to the best results for his patients. The laser’s proprietary cutting process results in better visualization and effortless separation of the flap, and enables the surgeon to begin the excimer laser ablation process immediately. This saves time and minimizes exposure of the stroma (the middle layer of the cornea). The laser’s ability to create ultra-thin flaps can also be effective for patients who are not ordinarily laser surgery candidates, such as those with thin corneas or extreme myopia.
When compared to other femtosecond lasers, the Ziemer FEMTO LDV™:
- is small, mobile and easily fits under excimer lasers, eliminating the need to move the patient
- reduces procedure time by being 3 to 5 times faster than all other FS lasers
- is more gentle to the corneal tissue
- reduces discomfort, inflammation and the risk of unwanted nighttime side effects
- is more precise, more predictable and safer
- has a shorter recovery period
- is more likely to achieve 20/20 or better vision
While some doctors argue that lasers are better than blades for cutting corneal flaps, both types of LASIK surgery are successful and achieve comparable results. Traditional blade LASIK with a microkeratome is widely believed to be faster and more comfortable for most patients. On the other hand, bladeless LASIK is often considered more precise and less risky.