Z-LASIK and iLASIK laser eye surgery explained

OK. lots of new laser eye surgery names appearing, so let’s confirm what they mean!

Z-LASIK: means blade free LASIK using the new Swiss Ziemer laser to make a corneal flap, rather than a traditional blade.

iLASIK: means blade free LASIK but using the American Intralase laser to make a corneal flap.

So, simple so far. Z for Ziemer’s laser and i for Intralase’s laser. Both of these devices allow elimination of a blade to make a physical cut in the cornea. Instead they use millions of precise laser pulses to create a very accurate flap, removing the potential risks associated with a metal-blade mechanical system.

Click here to watch an FDA animation of mechanical blade LASIK (N.B. Caution: watching this will put you off ever having bladed LASIK in the future! You will definitely want to opt for all laser LASIK after this!)

So what’s the difference between Ziemer and Intralase lasers?

The Ziemer laser is a new system, with potential advances upon the American Intralase laser flap maker. Ziemer’s lasers, called the LDV, appears to eliminate occasional complications found with iLASIK. Some iLASIK patients (around 7% quoted at time of writing) get a marked discomfort and aversion to light after laser vision correction, know as “transient light sensitivity”. Intensive anti-inflammatory medications can resolve this condition.

This side effect is not seen with Z-LASIK, possibly because of a much more tightly focused laser energy pulse and greatly reduced energy per pulse, compared to Intralase’s looser focus and wider dispersion of energy in the cornea.

Studies are ongoing to compare the two systems in greater detail.


Background on the LASIK procedure:

Creating the corneal flap is the first stage in a LASIK procedure. Treatment to correct your eyesight is actually done on the corneal tissue that’s below the surface and access to it is done by making a surface flap and folding it back (quite painlessly!).

This flap creation is critical for a successful result of your LASIK surgery – it needs to be of exactly the right thickness and in exactly the right place. When the surgery is completed, it’s easily folded back into position and acts as a delicate bandage over the treated eye. It heals up by itself.

The microkeratome devices used in traditional LASIK surgery are hand-held tools with a steel blade that oscillates, moving back and forth at very high speeds. When used expertly it makes a good flap but the thickness can vary more than laser flaps and they can be more irregular, tending to be thinner in the centre.

LASIK complications are quite rare. Fact. But when they do happen, they often arise from a poorly created corneal flap. Use of new femtosecond lasers (Ziemer or Intralase) greatly reduces the likelihood of any such complications.

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Filed Under: EducationLASIKSafetyTechnology

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About the Author: Mr. Dave Allamby FRCS FRCOphth is a leading London-based laser eye surgeon. You may have seen him on the This Morning TV show with Phillip Schofield and Fern Britton or read one of several articles in the national press, recently for treating Denise Van Outen, rock giant Rick Wakeman and broadcaster Paul Ross. David is Medical Director at Focus Laser Vision, known as a world-leading clinic in the treatment of presbyopia, or age related loss of close vision. Focus Laser Vision is also London's only clinic to offer next-generation Z-LASIK laser eye treatment for short sight, long sight or astigmatism.

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  1. Rick says:

    Hi David,

    I got my ilasik done 3 yrs back, my left eye is plano. But my right eye
    has -.5 D of astigmatism. Need your advise if I can GE an enhancement done or not..? Will await ur reply.

    Thnx
    Rick

    • Dave Allamby says:

      Hi Rick
      You will need to check with your clinic, but overall 0.50 of astigmatism is a pretty low amount and not usually enhanced.
      Regards, David

      • Rick says:

        So wud you enhance a -.5 dioptor.?

        Pl confirm, n if there is any technology / laser coming soon
        To correct such enhancements.

        Will await ur response here.

        Thanks.
        Rick.

        • Dave Allamby says:

          hi Rick. I have done some 0.50 enhancements, all fully successful, on my own patients where I know the eyes, corneal flaps and history, and for whom this error was very symptomatic. It is possible to do if your success rates and accuracy are very high. But I don’t perform these on patients operated elsewhere where I don’t know the patient or how well the original procedure was performed, any problems with the original flap creation etc.
          No other technology I am aware of targeting very small amounts, but I will post here if something is coming out.
          Regards, David

          • Rick says:

            This is what confuses me, as per my doc he says that there are chances of over correction. So he asked me to put lubricating drops but how long can one keep spending on these drops. What to do it’s been 3 yrs now n can it be performed safely after theses many yrs. pls give me best advise so I don’t get confused further.

            Rick

          • Dave Allamby says:

            hi Rick
            Your doc is right that there is a risk of overcorrection. So basically you might be better after treatment, but you might be the same, or even could be worse than now. You may be best to not have any enhancement.
            Thanks
            David

  2. Miranda says:

    Hi Dave,
    My power in Right eye is -7.75 sph & -1.25 cylindrical
    and Left eye -7.75 sph & -1.75 cylindrical. Pls let me knw
    what is the minimum cornial thickness required
    to get a ilasik or zlasik procedure.

    Thnx.
    Miranda

    • Dave Allamby says:

      Miranda, will depend on which excimer laser you use. The WaveLight laser we use takes less tissue away than some others, and with that laser you would need approx Right: 530 and Left 535 to be suitable, assuming a 6mm optical treatment zone, and around 550 if you have a 6.5mm optical zone.
      Regards, David

      • Miranda says:

        Hi David,

        My cornial thickness in Right is 496 micron and 501 micron in Left. Pls advise

        Thnx
        Miranda

        • Dave Allamby says:

          hi Miranda. unfortunately your corneas are thinner than average and not thick enough for a full correction, either LASIK or PRK. A maximum treatment will still leave your around -1.50 and hence still needing glasses.
          Regards, David

  3. Alisha says:

    Hi Dave,
    What is your advise on the new technology The Refractive Lenticule Extraction (ReLEx) method in comparison to ilasik or zlasik, Is it far superior and better and what are the pros n corns of it, are there any disadvantages aswel for ReLEx. Await your expert response here.

    Regards
    Alisha

    • Dave Allamby says:

      Hi Alisha. that’s a good question. I will write again summarising the clinical data so far available on Relex. Briefly, it is a very new treatment so not a lot of clinical outcome data available so far but is a very interesting approach using only a femtosecond laser. Certainly not ‘far superior and better’ but does appear to have comparable outcomes for high levels of myopia, compared to what we achieve using Z-LASIK.
      However, in a recent article respected US surgeon John Doane who is one of the US investigator for the Relex FDA trial noted “1% to 2% of eyes losing 2 or more lines of BSCVA”. This worries me as Z-LASIK has zero % of patients losing 2 or more lines of vision (vision which cant be recovered with glasses and hence a permanent loss), whereas Relex, at least to date, has 1 in 50-100 patients with such a marked loss according to John Doane.
      But, this is a new treatment and should improve over time. For the moment, you will be best to choose femto-second LASIK at a quality centre, with a very experience surgeon.
      thanks. David

  4. Nick says:

    Hi Dave,

    I got my ilasik done in yr 2010, it was a custome view one. Prior to my surgery my prescription was approx -.8 both eyes and my corneal thickness was approx 490 both eye n post surgery it’s 330 microns. Now my left eye is perfectly fine 6/5 but there is a bit of astigmatism on my right eye say -.5. So I did consult my doc. again for a enhancement for which he said that usually they do not do enhancements for small power as there are chances of over correction and I won’t like it, if over corrected. But, he did mention that although he can do it but he wud want me to avoide it and use systain drops instead to cater to my problem of strain on right eye or eye fatigue. Can u confirm if in future there is any technique which can correct this wo any risk invonved or what shud I do…shud I for enhancement or not…? Need ur expert advise here…as this astigmatism bothers me at times and don’t knw how long I will have to put these drops to address the issue. Pls advise

    • Dave Allamby says:

      hi Nick
      You had a very high degree of short-sight before LASIK, and it has been overall a very good correction with better than 20/20 in the left eye, and as you say a small amount of astigmatism of -0.50 dioptres in the right, which is a low amount, particularly coming from -8.00. Enhancement can be quite hard to get a real benefit when trying to fix very small errors, as there is a real chance you might end up worse than before. It may improve, but could end up more problematic for you.
      So please proceed with caution if you are thinking of doing this, if your surgeon would agree. His or her advice is correct, and I too would recommend to avoid it. Some people are sensitive to even small refractive errors, especially when the other eye is perfect, and do find problems with the vision as you yourself have. But coming from a severe -8.00 dioptres, it really has been an accurate treatment overall. It is hard to advise you more here, but do balance the pros and cons of any enhancement. The Systane drops are to help any dryness and do not correct the astigmatism error. But if there is evidence of dryness though, the lubricants will indeed help optimise the surface and quality of vision to get the best from your eyes.
      For other technologies we are waiting. I expect we may have in the coming years a method to make accurate small corrections in the cornea without breaking the surface and so reducing risks markedly.
      Regards, David

      • Nick says:

        Thnx David…for d golden advise here, rly appreciate u being honest n blunt wd facts. So, u suggest I shud try n keep it off my mind…it’s just at times I do feel bit strain n fatigue on rgt eye. But, you right I shouldn’t not make things difficult in haste, instead will wait for the new technology to cater to my need. Rest I don’t exactly feel d need of glasses on right eye though…but it does bother me at times and pushes me to think abt it.

  5. jenn says:

    the place i wanted to get my surgery done uses allegretto wave light? is that okay? i have stigmatism and they said my cornea is shaped like a football, so they would have to reshape it.

  6. Irene says:

    Hi David,

    Are you able to advise me if I would be suitable for Z-LASIK?
    I have wore glasses since I was 8, and contacts since about 17 years – am now 29.
    My current prescription from my optician is
    RIGHT -5.50 LEFT -3.25 -1.25
    My right eye has been the same since 2007 but my left eye pescription has been different:
    2007 LEFT EYE -4.50 +0.75
    2009 LEFT EYE -4.25 -0.25
    I have recently been for a couple of laser eye consultations locally and they have my LEFT eye as either -3.00 -1.75 or -3.75 -1.50 and my RIGHT eye as -5.75 -0.25 or -6.00 -0.50
    I am seriously considering laser eye surgery and would like to have it done with FOCUS due your success rate but am worried about if my left eye has stabilised? I thought it had.
    Also I have had trouble with my contact lenses over the last 6-12 months. I have had a couple of reactions to contact lens solution and also have some dry eye problems and mild bleuphatirits. Though my optician (and the optomoterists I’ve seen at the laser eye consultations) seem to think the dry eye is from contact lens intolerance. Would I still be suitable for laser eye surgery?
    Also please could you let me know what my chances are of achieving 20/20 vision due to my prescription?
    Many thanks.
    Irene

    • Irene says:

      Forgot to add my corne thickness is around 506 microns.
      I would have to travel to London as don’t live locally, would it be easy to arrange consultation/surgery etc.
      Thanks
      Irene

    • Dave Allamby says:

      hi Irene. I think one issue here is the change in astigmatism in your left eye. It was low in 2009 at -0.25 (or -0.75 in 2007), and now is measured at 1.75D. It could relate to how long your contact lenses were left out prior to the test, if at all. I like to see a stable prescription, with only 0.25 change over 1 year. There is also progression of the myopia in your right eye, of 1.25 dioptres over 1 or 2 years (depending if your current opticians measurements were from 2010 or 2011 – not clear which it was).
      I suggest waiting and having a repeat test at the same optician in 1 year.
      Best regards
      David

      • Irene says:

        Hi David,

        Thank you for your response. I normally have my contact lenses in when going for my eyesight test with my Optician but did have them out for 24 hours when having the laser eye consultations.
        I have recently changed Optician so will wait and see what they get my prescription as when I’m due an eye sight test.
        Thanks
        Irene

  7. mike says:

    Dave
    i m 18een and unfortunately i have a high myopia -7.5 for both eyes and a thin cornea 470 so lasik is not adequate for me thats why i m thinking of having an ICL surgery so i really need ur opinion about this one and is it safe as lasik and is it Guaranteed i really dont want to lose my vision . thnxx dr
    regards
    big fan :)

    • Dave Allamby says:

      hi Mike, high prescription and thin corneas mean yes not suitable for LASIK or PRK. An ICL is a much better option than it used to be. We prefer the Starr ICL, now on its 4th version. You will be best to wait until you are 21 for the eye to slow its growth. Main long term risk is cataract, which currently happens in less than 5% of cases. This can be addressed with more surgery if necessary. Presumably future versions will help reduce this risk, which should be available by the time you are 21. WIth regards, Dave

  8. Brian says:

    Hi

    I am 54 and have -7.5 in my right dominant eye and -11.5 in my left eye with a bit of astigmatism in both eyes and about 1.5 of presbyopia.

    I have had a consultation with moorfields who have suggested that they can fully correct the right eye and partially correct the left eye to give me monovision. I have tried monovision with hard lenses and can tolerate it reasonably.

    I was about to go to moorfields but then read about laser blended vision. Is that a better option and is Focus better than Moorfields.

    Being a cautions person, I always assumed Moorfields would be the place to go but is your technology ahead of theirs ?

    • Dave Allamby says:

      hi Brian. Monovision or blended vision can be a good option for your prescription, assuming your corneas have sufficient thickness. For technology, I think that the Ziemer laser outperforms the Intralase, as used at Moorfields, and a recent study comparing the two confirms that. The Intralase market share is falling, as surgeons adopt the Ziemer Z-LASIK platform. For the excimer treating system, the WaveLight laser is my clear choice for myopia, especially high myopia.
      With best regards, David

  9. carrera says:

    dear dave
    so this is my situation :
    -myopie -8.00 for both eyes :(
    – age 18een
    and when i went to the eye doc in my area i realise that the thickness of my cornea is 481 for both eyes so the doc told me that i cant have lasik surgery or phemto-second or epi-lasik is that true and is there another solution for my condition and can my cornea get thicker by te time pls help and thnx thnx for ur help dave
    Regards

    • Dave Allamby says:

      hi Carrera
      You unfortunately have a very high prescription and thin corneas, and your doctor is correct that there is not enough tissue there to fully correct your problem. Your corneal thickness will not increase with age, sadly, so waiting will not help. Your only treatment option is an implantable contact lens (ICL). If you do this, then you will need ongoing monitoring of the health of the inner layer of your corneas each year thereafter.
      Best regards, David

  10. Allen says:

    Dave,

    Thank you very much for providing all of this insight on LASIK procedures–it’s very informative. I have heard recently that some doctors prefer EPI LASIK simply because it allows the eye (the cornea, I assume?) to fully heal, which typically leads to fewer complications down the road. Naturally there are drawbacks to this procedure as well (pain, variations in vision during healing process, haziness of vision during healing), but I was wondering if you could give your thoughts on the benefits of having the eye be fully healed afterwards, as opposed to having a flap remaining (and also potentially leaving open the possibilty of it getting snagged or otherwise injured later on).

    • Dave Allamby says:

      hi Allen. I don’t think that surface laser (PRK, LASEK, EpiLASIK) will lead to fewer complications down the road compared to LASIK, and 2 decades of LASIK hasn’t thrown up any issues for flaps long-term. We only perform about 3% of cases with surface laser now. I think you will get the drawbacks from surface laser that you mentioned but without any real gain down the line. Direct trauma to an eye, sharp trauma, sufficient to move a flap is a pretty rare event so the only time I advocate PRK for occupational reasons is for martial artists who do regular sparring to the head, and where they are not wearing boxing gloves.
      Hope that helps. Dave

  11. Dawson Richmond Sso says:

    Just wondered if the Z-Lasik machine had the anti- eye movement technology that the I- Lasik has etc if customer Px moved their eye during the procedure it would auto realign itself and continue. Thankyou

    • Dave Allamby says:

      hi. The Z of Z-LASIK refers to the Ziemer laser that is used for flap creation, and so doesn’t need eye tracking. That belongs to the excimer laser used for treating the vision problem. All excimer lasers use anti eye movement tracking technology now, so moves together with your eyes, and ensures each pulse is placed in the right location every time.
      Best regards, Dave

  12. Joe says:

    Hi Dave – i was about to do Z lasik but recently read some articles and saw videos of people that had bad experiences with lasik, not necessarily z lasik but in general.

    i obviously am a little concerned and i am wondering if you could describe the possible issues with z lasik if any.

    thanks in advance.

    regards

    Joe

    • Dave Allamby says:

      hi Joe WIth millions of treatments carried out, there are certainly some patients who have problems post-op, even things that only happen one in a million. It must always be a considered choice of benefit to risks. We do not find specific problems with Z-LASIK. The issues that come up are occasional enhancement needed, but no more than 0.5-1% of cases, which is a very low rate. You want a surgeon who is experienced with the Ziemer laser, e.g. 2-3000 cases done. Choose a clinic that has a good excimer laser, e.g WaveLight, Schwind.
      If you have a specific question, please let me know.
      Regards, Dave

      • Joe says:

        thanks Dave. i will ask them which specific machine they have as i was not aware that made a difference.

        my other concern was that this is a “relatively” new procedure and there doesn’t seem to be enough data on how this surgery can affect ones eyes as they age. i.e someone who does this surgery in their 30′s, do we know how their eyes will be affected by this at the age of 60 or 70 or older?

        thanks in advance

        • Dave Allamby says:

          hi Joe
          Its an interesting point. I believe that with more than 20 years of laser eye surgery experience, we now know how the eyes respond long term, and there aren’t any problems surfacing late on. I don’t see a pathophysiological process that would induce very late changes. I think it will also come down to preference, and feeling towards early or late adoption. Some people will want e.g. 50 years of follow up before going ahead, which is fine, and this is always a personal choice and not an essential procedure. It will come down to the individual, although I do not believe we will see any late issues whatsoever.
          Regards, Dave

  13. Becky says:

    Hi Dave,

    I’m looking to get laser eye surgery in the USA. I have decided that I definitely want Z-lasik and I have found two very reputable doctors in my area that use Z-lasik. Their differences, however lie in the laser they use for vision correction. What excimer laser is the best out of these three: Alegretto Wavelight 200 HTZ, B & L Zyoptix, or VISX Star S4? Thanks for your help.

    • Dave Allamby says:

      Hi Becky, interesting question. It will depend on your prescription. Can you give me the approximate numbers? thanks Dave

      • Becky says:

        The prescription from my contact lens box reads: right eye pwr -2.00 -1.50 x 110 and left eye pwr -1.00 -1.50 x 70. I also have an astigmatism. Thanks again for you help.

        • Dave Allamby says:

          Becky, Thanks. with your relatively low prescription (by my terms!), you can safely go with either the WaveLight or VISX S4 lasers for your Z-LASIK. Both will do well. Make sure you get the CustomVue treatment if you go for the VISX, which is necessary to get the best results on that machine. WIth the WaveLight a wavefront optimised procedure will give excellent results. Final choice will always be down to the surgeon who will perform the op, once you have narrowed down the the right lasers.
          Regards, Dave

  14. carrera says:

    HII Doctor
    i m 18een and today i went to an eye doctor and i found that i have -7 to both eyes (myopia) and its the same since one year and i really want to have a lazik surgery so i came to u to advice me and tell me if i can have it tthnxxxx

    • Dave Allamby says:

      hi Carrera
      Yes, you may be suitable as your prescription has been stable for 1 year. It will depend on other factors such as corneal thickness, pupil size at night, etc. Book for a consultation at a local eye clinic and they can advise you.
      Regards, Dave

  15. zlasikrocks says:

    Hello Dave,
    i am mailing from Canada, we don’t have z-lasik here. Can i come over in UK to do z-lasik and fly back after the surgery?
    is there any complication for flying after 1-2 days of surgery? I am 28 ,and my eyes are minus 5. How much approximately it will cost for me for z-lasik? Also how i will go for the post-surgery check-ups?

    Give me your valuable suggestions.

    • Dave Allamby says:

      Hi. Thank you for your email. Flying after Z-LASIK is not a problem. You would want to be here for a few days for the 1 day check then review say 3 days after to give you the all clear. Those are the most important safety checks to rule out infection, inflammation, etc. We normally review once more at 3-6 months for routine cases to confirm the prescription at zero, and you could get get this done locally. Needing an enhancement is rare, around 0.5% at our clinic for this prescription. Treatment fees for -5.00 both eyes are £3250 for Z-LASIK. Please let me know if you have any other questions.
      Best regards, Dave

    • Erin says:

      We do have z-lasik in Canada. I will be getting it done in a few weeks. The cost is $4200 for both eyes and it is done in BC

  16. Kevin says:

    Hi Doctor,

    Would you please advise if “zlasik” is still better and newer technology compared to “ilasik with iFS Advanced Femtosecond Laser”?

    Thanks

    • Dave Allamby says:

      hi Kevin, I prefer the Ziemer system (Z-LASIK). We have the brand new Ziemer LDV Crystal Line system, and it is a remarkable flap creation too. It is 33 times faster repetition rate than the latest iFS 150KHz model, with energy per pulse far lower, tighter energy focus and the shortest suction-on time. We can do both eyes safely and very accurately in around 6 minutes.
      Best regards, David

      • Kevin says:

        Hi Dave,

        Thanks for the reply. However I am still confused with the surgery in my area that offer me the z-lasik and ilasik.

        One place only offer me the ilasik which cut the flap by using intralase with iFS Advanced Femtosecond Laser, and use VISX Laser.

        However, I am not to sure with the place that offer me with both z-lasik and ilasik. They said that they use ziemer to cut the flap (which is using (intralase femtosecond) and using excimer laser. For the ilasik, it seems that they are using intralase but not VISX Laser, instead they use allegretto wave which made me more confused.

        Please let me know which one is better?

        Many Thanks

        • Dave Allamby says:

          hi Kevin
          Z-lasik means using the advanced Ziemer femtosecond to create the flap, with vision being corrected by any excimer laser. iLasik refers, as you say, to a procedure with an Intralase brand femto and a VISX laser to correct vision.
          The best option for me is using the Ziemer femto with the Allegretto Allegretto Wave excimer laser. If you cant get that, then the Intralase femto to create the flap, plus WaveLight Allegretto for vision correction would be my next choice.
          Best regards, Dave

          • Kevin says:

            Hi Dave,

            So you value Allegretto Wave higher than VISX 54? And is this better in any type of eyes? Such as astigmatism / short / long sighted / night vision?

            And just to double confirm, from your last reply, are you referring the term of Allegretto Wave excimer laser and WaveLight Allegretto as the same?

            Sorry I asked lots of question

          • Kevin says:

            Hi Dave,

            So you rate Allegretto Wave higher & better than VISX? Is it better for any specific type of eyes? Or generally better for astigmatism / long / short sight / poor night vision.

            Also, on your last reply, do you refer Allegretto Wave excimer laser and WaveLight Allegretto as the same thing?

            Many thanks

          • Dave Allamby says:

            hi Kevin
            Yes, I rate the Allegretto as better than the VISX for all prescriptions. The VISX performs well for short-sight up to -6 dioptres, almost as good as the WaveLight. Above -6D the VISX performance falls away compared to the WaveLight platform.
            The WaveLight company is based in Germany. They first produced the Allegretto Wave laser with a 200Hz speed. Later came the improved Allegretto Wave Eye-Q laser running at 400Hz and with other improvements. You want to be treated on the faster Eye-Q version. With this laser, combined with the Ziemer LDV Crystal Line femtosecond laser to create a Z-LASIK flap, we achieve 100% of patients with 20/20 or even better, even up to high myopia.
            With best regards, Dave

          • wayne says:

            dear dave,
            as you compared laser platforms,how does the latest zyoptix rate in relation to the eye q for low to moderate myopia
            thanks

          • Dave Allamby says:

            Hi Wayne, hard to say actually as we are lacking good comparative data. Ultralase currently claim 99% achieve binocular 20/20 at 6 months for their latest B&L, and OE claim 98% with the VISX platform. We get 100% to 20/20 with the WaveLight Allegretto Wave Eye-Q 400Hz plus Ziemer LDV for the same myopia treatment range.
            Regards, Dave

  17. carrera says:

    hi doctor
    i m 17 and i will 18 in about 10 months an i want to have LASIK surgery this summer what can u advice me
    thnx

    • Dave Allamby says:

      Hi Carrera
      You should have a sight test now and again when you are 18. If there has been no change, no more than 0.25 dioptres increase, then you could be eligible for surgery at 18. If it has increased by 0.50 or more, I would wait and recheck when you are 19.
      With best regards. Dave

  18. Albert says:

    Hi Dave,

    just wondering if normally Z-Lasik can fix myopia up to -9 if cornea thinness is not an issue here??
    is there big chances on getting halo/bad vision during night time after doing Z-Lasik?

    Thank you

    • Dave Allamby says:

      hi Albert
      Treating myopia up to -9 isnt a problem in itself, assuming the pupils aren’t huge. If you get some halo or glare at night time now, you may well still have it post-op, typically to a similar degree. You may well have some night glare during the first few months, which will gradually lessen, but which isn’t usually problematic.
      With best regards, Dave

  19. Paul says:

    Hi Dave,

    My girlfriend has just been for a consultation today with a view to undergoing laser eye surgery. Unfortunately owing to her long sighted vision being +5 in her right and +6 in her left eye she was informed that she is unsuitable for surgery. I realise that the tools used in corrective surgery (like most things technology related) are continually being improved and developed. Are there any advancements being planned or tested that will eventually mean she can undergo laser treatment?
    Kind regards

    Paul

    • Dave Allamby says:

      Hi Paul
      Depends on her age. If she is young there isnt anything I could recommend now or in the near future. If 40+, then lens implants (refractive lens exchange) can rectify the problem.
      Best regards
      Dave

  20. andri says:

    Dear Dave,
    i just consulted with a doctor about lasik, i think i prefer Z-lasik, but the doctor said my cornea is too thin for Z-lasik, so he recommend i-Lasik for me. Is it true? I think Z-lasik is the latest technology compared with i-Lasik, but why Z-lasik required thicker Cornea?

    Thank’s alot for your explaination,

    Regards,
    Andri

    • Dave Allamby says:

      Hi Andri
      That makes no sense whatsoever. Z-LASIK can cut down to 80 micron flaps which is thinner than you would ever want to go, and as thin as i-LASIK flaps.
      Regards, Dave

      • Matt O says:

        Hi Dave,

        Just jumping on this thread as it relates to my question:

        Optimax told me my cornea is too thin for laser surgery and i have to have ICL. I immediately dismissed this and was depressed for a few days. I am 36 and have worn glasses since 1 was 7 years old.
        I have since found out that they only do Lasik and ICL…
        My question is: will z-lasik be able to operate on thin cornea patients better than i-lasik?
        Should get a second opinion for maybe LASEK?
        My prescription is -7.00 and -6.50 and 0.50 astigmatism in the left eye. I have not received my pachymetry details from Optimax, so can’t say precisely about how thin my lenses are. Would you recommend z-lasik? and how much would it be if you did.

        Thanks

        • Dave Allamby says:

          hi Matt
          Please can you find out your pachymetry measurements and also your pupil size diameter in the dark. They will have measured both of these at your Optimax consultation.
          Thanks, Dave

  21. Chris says:

    I had Lasik done in 2001 using the blade flap. I was told some years later when I went back asking about getting a touch up performed that re-opening the flap isn’t a good idea.

    Now my distance vision is getting poor so I’m considering a second Lasik procedure.

    What are my options for getting Lasik done a second time?

    I also read a second Lasik procedure can correct the night time halos some people experience, is this correct?

    • Dave Allamby says:

      Hi Chris
      Technically you can re-lift an old blade flap but it isn’t a good idea as can lead to complications. Recutting a blade flap can sometimes lead to worse optics so we generally do don’t do that. There is ongoing research into recutting a flap using a femtosecond laser. However, you would be better having a PRK procedure for an enhancement at this stage, and using mitomycin C to prevent haze.
      Regards, Dave

  22. Syaifullah says:

    Hi Dave,
    You said that the mechine of zlasik is more expensive than ilasik, but why in Indonesia, the cost of zlasik is more cheaper than ilasik? Could you recommend me about what kind of lasik and clinic in Jakarta. Thks & regards, Syaifullah

    • Dave Allamby says:

      Hi Syaifullah. Pricing will vary between clinics, technology, service and with the experience of the surgeon, which is very important, so the cost is not just on which machine is being used. Sorry, I am not familiar with clinics in Jakarta, but use the principles I have written about on how to choose a clinic, in several previous post. Click on the Clinics tab and you can see all my posts there.
      Best regards, Dave

  23. Edwin Lam says:

    Hi, my girlfriend is planning to do lasik in hong kong and the hospital said it depends on the diagnose on whether she can or what type of lasik she can do. They said they will use the latest lasik to treat her if she meet the requirments. And she said the latest type is Intralase, but all over the web I have found a newer type call z-lasik which is also described above.

    Would you please advise on the differences between the 2 technique?
    Are there any big disadvantages using the Intralase technqiue?

    A Million thanks in advance!

    • Dave Allamby says:

      Dear Edwin
      These are two types of femtosecond lasers – one is the Intralase from U.S., and the other the Ziemer from Switzerland. Both systems will cut a good corneal flap so there is no big disadvantage, and both preferable to a blade cut. You can safely go with the Intralase where you are. I prefer the Ziemer laser for LASIK (when it is called Z-LASIK) over the Intralase, and chose Ziemer for my clinic, even though the more expensive.
      Best regards
      Dave

  24. Jen says:

    I am considering LASIK. I live in USA so was going to go for ilasik until I heard of zlasik ( i’m from UK and would travel back to have zlasik if it’s better). In USA they also offer wavefront technology with ilasik and I wondered if that is available in UK and also is it worth it?

  25. A.K. Sethi says:

    When you say both iLasik & Zlasik are bladeless technique, then why should one go in for z-lasik? what are the advandages of zlasik vis-a-vis ilasik?

  26. Manish says:

    Hi Dave,

    What do you mean by “choice of treating (excimer) laser and size/type of prescription. Zeimer is not available in my area as well. I was planning to go for i-lasik. However, reading about the complications like eyes getting dry and ofcourse “transient light sensitivity”, I just feel that I should wait for Zeimer. Please suggest.

    Regards,
    Manish

  27. Brian says:

    Dave,

    Z-LASIK is not offered in my area. However, IntraLase LASIK is. Are there any long-term differences in the end result between the two? I’m wondering if it’s perfectly alright to go ahead with iLasik, or is it worth waiting for Z-LASIK to become available?

    Many Thanks,
    Brian

    • Dave Allamby says:

      Brian
      I think both the Intralase and the Ziemer femtosecond lasers will do a good job for a blade free flap. The bigger question is the choice of treating (excimer) laser and the size/type of your prescription.
      Regards
      Dave

  28. Irene says:

    Hi David,
    Sorry I forgot to add if you could answer with cornea thickness of around 506 microns if I would be suitable for ZLasik or would I be better off with LASEK?
    Thanks again.
    Irene

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