Q Does the wavefront guided LASIK mean you will cut a flap or remove the top layer (epithelium)? Please also advise which machine you use for the op. i.e. – nidek, bausch & lomb, allegreto , etc.?

Ans I shall try and make this simple for you to understand, as your Q’s revolve around technical details. Most patients understand the complex terminologies better when explained as under….

Today no one is going to tell you that they are using a black and white TV, because without doubt you will know that this is an older technology as compared to colour TV, this is an analogy to non wavefront (no laser centre will say that their laser is a non wavefront one as it equates it to something old).

However in wavefront, you have different lasers doing the job, just like you could get a colour TV which is Akai or Onida, or something completely high end, HI Fi Sony 3 D TV! that’s the comparison of which ‘laser’ is being used i.e. Nidek, B & L or what we use is the Concerto Laser. For specific advantages, the high end TV’s cost more.

Now coming to the exact technique or procedure of LASIK regarding ‘flap’ epithelium’ etc. Again, to give you another example, please imagine a mattress with a bedsheet. The mattress is comparable to the cornea. In LASIK (with whichever laser you use, wavefront or non wavefront, Nidek, B&L or Concerto) what is done is a ‘flap’ is created in the thickness of the mattress. This is not done by the laser mentioned, but by a step prior to using the actual laser.

The thickness of the flap (thinner the better, where we use disposable kits to give you a thin flap to help save cornea). The flap is lifted and then the laser reshapes the cornea according to your powers and data collected in the check up (here again we have a cornea saving advantage as the laser we use, the Concerto, uses less cornea to remove powers as compared to most lasers used today).

Now, if we do not want to disturb the cornea or save as much of cornea as we can (in dry eyes / thin cornea, detected by Dr Shroff during check up), we do EpiLASIK, which is take the bedsheet away (the epithelium) and do the laser reshaping on the first layer of the cornea (without having made any ‘cut or flap’). This ‘bedsheet’ or epithelium grows back in 4 days time. This is EpiLASIK. So EpiLASIK is just a variation in the initial steps of LASIK, the laser treating powers remains the same which is the Concerto Laser in our case.

Marketing terminologies have made it more difficult for a lay person to understand the exact technology/ technique clearly. However, I hope the above helps understand LASIK/ EpiLASIK better.

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