Many people make the mistake of thinking all excimer lasers, when approved by the FDA for laser vision correction, perform about the same. This is one of the biggest misconceptions among individuals persuing laser vision correction. Just like there is a difference between a Mercedes and a Fiat, all lasers approved by the FDA for LASIK perform differently. Each laser has its own advantages and disadvantages, which is virtually impossible for the average consumer to distinguish for his or herself.
Dr. Patel and his laser technician are familiar (and certified) on all the excimer lasers listed below. Experience using these lasers is the only way to really know the difference each one can make when treating any individual. Always make sure that the lasers are equipped with the newest upgrades available. The newest technology improves performance and is done for a reason, leading to better results for the patient.
Finally, lasers that are kept in a climate controlled (temperature and humidity) operating room, are more dependable than mobile units or lasers that are shared by numerous doctors. Envision Laser Centers owns our lasers that are always kept in a climate controlled operating room. We do not let outside surgeons and inexperienced staff use this equipment. Our lasers are kept under corporate service contracts and routinely serviced by engineers to ensure the best performance for our patients.
Baush& Lomb Technolas 217z 100hz Zyoptix System
The Bausch & Lomb Technolas® 217z 100hz Zyoptix(TM) System for Personalized Laser Vision Correction is the world's leading excimer laser for personalized vision correction. Its innovative "flying spot" technology produces an extremely smooth corneal surface.
The Technolas® 217z 100hz Zyoptix(TM) System uses a state-of-the-art feedback mechanism that helps to ensure every pulse is placed as prescribed. The Technolas 217z wavefront-guided laser is designed ergonomically for LASIK which means greater comfort for you and greater flexibility for your surgeon. Learn more about the Bausch & Lomb Zyoptix(TM) System capabilities to provide customized laser treatment that is unique to each eye.
The only platform clinically proven to reduce night time glare in most individuals.
Envision Laser Centers' Ranking List Of FDA Approved Lasers
(Dr. Patel and staff have used and been certified on the following platforms. This is our personal rankings.)
- WAVELIGHT ALLEGRETTO
The WaveLight Allegretto System is the newest and fastest excimer laser system to win FDA approval in the past 5 years. In 2004 and 2005, the Allegretto Wave held a 26% marketshare of all newly installed excimer laser systems worldwide. Including both WaveFront optimization and PerfectPulse Technology, the Allegretto Wave is arguably the safest and most effective excimer laser system on the market today.¹
- VISX CUSTOMVUE
Approved by the FDA for safety and efficacy, the Advanced CustomVue™ procedure is a
custom-tailored laser vision correction procedure designed to correct the unique imperfections
of your eyes. Whether you're nearsighted, farsighted and/or astigmatic, the
Advanced CustomVue™ laser vision correction procedure can help you achieve your
Personal Best Vision™.
- NIDEK EC5000
The EC-5000 CX III is one of the most reliable excimer lasers on the market today. The ergonomic EC-5000 CX III is designed to reduce or eliminate myopia and hyperopia, with or without astigmatism, and offers the latest in advanced technology — all without per-procedure fees.
FDA APPROVALS
Although all approved excimer lasers meet safety and effectiveness criteria established by the FDA, certain people may be better off with one type of laser over another.
Four Must-Knows About Comparing LASIK Laser Outcomes
When evaluating lasers, you may be drawn to information gathered during FDA clinical trials leading up to approval. But you should keep these points in mind when considering FDA data:
Today's results are often better than FDA data. By definition, FDA trials occur during the early period of a laser's life cycle. Manufacturers are allowed to and often do make technical improvements to the instruments, sometimes even while the lasers are still under investigation.
The surgeon's technique evolves as well, and usually becomes more advanced than the technique used in the FDA trials. This, together with increasing surgeon experience over time, means that results in actual clinical practice are often better than the initial FDA data.
FDA data in one study cannot fairly be compared with FDA data in another study. Manufacturers go to the FDA with various study designs, which often have differing endpoints and patient-enrollment criteria. Although all studies must answer certain basic questions regarding safety and effectiveness, they are not designed to be compared with one another.
A true comparison of Laser A and Laser B would require randomized clinical trials, in which patients would be randomly assigned to receive surgery by one laser or the other over the same time period by the same surgeons. FDA trials don't do that--although other, non-FDA studies sometimes do.
Studies don't cover every possibility. Just because you have a characteristic or condition not covered by the approved labeling of a laser doesn't mean the laser won't work for people with your characteristic or condition. It also doesn't mean that another laser approved to treat people with your characteristic will do a better job.
Remember, these studies have differing designs, and people with your characteristic or condition may or may not have been included, or their results may or may not have been analyzed, or there may have been too few such people in the studies to determine statistical or clinical significance.
Once the FDA approves a laser, your surgeon can use it any way he or she deems appropriate. This is true of all FDA-approved drugs and devices. This is commonly referred to as "off-label" use of an FDA-approved drug, device or laser. It's called a physician's practice-of-medicine prerogative, and there's nothing inherently wrong with it.
In fact, most advances in medicine occur because of off label uses of devices or medications. So this type of use can be critical in modern medicine.
For example, without "off-label" use of aspirin, no one ever would have known that aspirin (originally FDA-approved for pain control) is vital for reducing risk of heart attacks.
Armed with this insight, the informed consumer can begin to compare the commercially available laser systems approved for LASIK. Most discussion about these lasers surrounds the mechanisms they use to deliver the laser beam and track the eye during ablation.
Types of Modern Excimer Lasers Used for LASIK
Slit scanning lasers — Slit scanning lasers use relatively small beams linked to a rotational device with slit holes that enlarge. The laser beams scan across these holes during surgery, producing a gradually enlarging ablation zone. The approach provides a uniform beam and — potentially — smoother ablations than obsolete broad-beam lasers. The disadvantages include a slightly greater risk of decentration and overcorrection unless an eye-tracker is being used with the laser.
Spot scanning lasers — Spot scanning (or "flying-spot") lasers, which are the most common, use small-diameter laser beams (0.8 to 2 mm) scanned across the cornea to produce the ablation zone. This approach has the potential to produce the smoothest ablations, to more readily allow customized ablations and to better treat irregular astigmatism.
Wavefront-guided lasers — Many excimer lasers are connected to a device that detects and "maps" defects in the eye's optical system, based on how lightwaves travel through the eye. These wavefront devices individually guide the way the eye's cornea is reshaped to achieve a custom LASIK ablation. Both slit scanning and spot scanning lasers have the ability to be used for wavefront-guided treatments.
Excimer Lasers and Eye Tracking
Most modern excimer lasers have automated eye tracking systems to keep the laser beam on target. Studies have shown that eye trackers produce better outcomes and decrease LASIK complications compared with past lasers that did not use eye tracking systems
