All Laser LASIK

Commonly referred to as “All-laser LASIK,” “Intralase,” “bladeless LASIK,” and a number of other terms.  Z-LASIK is a technique that uses a special laser to create the corneal flap, rather than a microkeratome.

Typically used to treat:

  • Myopia
  • Hyperopia
  • Astigmatism


Z-LASIK logo

What is Z-LASIK?

Z-LASIK is a technique used to create the corneal flap in order to access the corneal stroma.  Rather than a microkeratome, Z-LASIK uses the Ziemer FEMTO LDV Femtosecond Surgical laser to create the corneal flap.

Many people choose to undergo the Z-LASIK procedure because they are uncomfortable with the idea of their eyes being touched by a microkeratome blade.

How does Z-LASIK work?

Stage 1: Accessing the corneal stroma

Z-LASIK – commonly referred to as the “ALL-Laser LASIK” technique because the corneal flap is created using a special femtosecond laser.

Stage 2: Laser Treatment

Stage 3: Closing Stage

Description: ZFLAP.jpg

For several years now it has been possible to create the flap using a femtosecond laser. This means that no blade is involved in the procedure. Over one million patients have already undergone bladeless laser eye surgery.

With a femtosecond laser, an ultra-thin corneal flap is created with ultra-high frequency pulses.  These pulses are very rapid and create separation in the layers of the cornea, creating the corneal flap, without the use of a micokeratome.

The laser-created corneal flap is gently opened to provide Dr. Lin access to treat the stroma with the chosen laser and correct your vision (Stage 2: Laser Treatment).



What are the benefits of Z-LASIK?

Compared to other femto-LASIK procedures based on older femtolaser technology, Z-LASIK offers many advantages that lead to better results:

  • Z-LASIK has an extremely low impact on the eye–The procedure takes only a few minutes per eye. The time the laser is in contact with the patient’s eye is reduced to a minimum.
  • Z-LASIK is comfortable and painless– Biomechanical superiority— the Femto LDV procedure creates flaps that are structurally superior and uniformly thin.
  • Flexibility– Thanks to the extremely high frequency of the laser pulses, the layers of the cornea are separated with unprecedented precision, creating an ultra-thin flap.  The Femto LDV procedure can be used to treat patients with higher refractive errors, thinner corneas, and even moderate-to-high astigmatism.
  • No inflammation– The laser energy used for Z-LASIK is about a 100 times less powerful than with other laser procedures. This is more gentle to the corneal tissue and prevents temporary inflammatory reactions of the eye.
  • Fast result– The recovery period is shorter; because of the superior nature of the Femto LDV flaps, patients heal faster
  • Fewer side effects– Z-LASIK enables Dr. Lin to enlarge the treatment zone. This reduces the risk of undesirable side effects such as dry eyes, deteriorated night vision or halos.
  • Better results– When compared to other technologies Z-LASIK provides a smoother stromal bed surface; and smoothes the edges for optimal flap closure.

Ziemer Femto LDV Laser

When compared with other “bladeless” technologies, the Ziemer Femto LDV laser also has a number of advantages over other Bladeless LASIK systems. These advantages include:

  • High frequency pulses (>1000 kHz) that are very short (~250fs) and are low energy (< 100nJ)
  • Pulses are small and tightly focused
  • More precise cutting plane than competing femtosecond lasers, meaning greater accuracy and precision
  • Less "shock wave" effect

The advantages of these technical breakthroughs are the reduction in possible complications related to all-laser LASIK. Especially important are the improved clarity of corneal flaps and the near-erasure of the opaque bubble layer (OBL), which can slow down treatment or lead to less than ideal results. More significant complications like vertical gas breakthrough that can lead to buttonhole flap complication and transient light sensitivity (TLS) are also significantly reduced with the ZiemerFemto LDV laser.

Who is a candidate?

The ideal Z-LASIK candidate does not differ very much from a typical LASIK candidate.Our ideal candidates for the refractive correction procedure are:

  • Individuals who are over 18 years old
  • Have healthy corneas and no major vision-related issues
  • Stable vision – No significant change in their vision within the past 12 months prior to the procedure
  • Patients who use glasses or contact lenses to improve their vision are ideal candidates

There may be times when IQ Laser Vision may need to turn away patients because they are not a good candidate for the procedure because our number one concern is not the number of patients we bring in but the quality of care and high level of service we provide.  That is why it is important to come in for our FREE CONSULTATION, in order for IQ Laser Vision to determine your candidacy and provide the best vision correction options for you. Click here to book your FREE CONSULTATION.

What you can expect?

The procedure is same as it would be for a standard LASIK procedure, except the corneal flap is created with the ZimerFemto LDV laser.

The experience gained from over 300,000 Z-LASIK treatments shows that a vast majority of patients:

  • Did not find the treatment uncomfortable or painful
  • Achieve perfect vision without glasses
  • Are more satisfied with the outcome than they expected
  • Would choose this method again and recommend it to others

What are the risks?

The risks with the Z-LASIK procedure is the same as it would be for any LASIK procedure.  Some potential risks may include:

  • Dry eyes
  • Halos (typically at night)
  • Variations in recovery time – nutrition, adherence to IQLV recovery guidelines, and activity level are some factors that may have an effect on recovery time
  • Genetic variations – age, gender, ethnic background, family health history – these may have effects
  • Corneal abrasion – in very rare cases

All risks are discussed and addressed before, during and after the procedure.  IQ Laser Vision is dedicated to answering any and all questions you may have to ensure complete conformability and proper expectations with the procedure. FAQs

Q: What are the odds of no longer needing glasses for distance with the laser procedure?

A: Studies have shown that nearly every patient experiences a marked improvement in their vision as compared to their previously uncorrected vision with glasses or contacts. Over 99% of patients will attain corrected vision that will meet or exceed the DMV licensing requirements.

Q: Will I experience any pain with this procedure?

A: Every effort is made to ensure that our patients have a very comfortable experience during and after their procedure. Most patients experience no pain and are able to return to their routine activities the following day.

Q: I am over age forty. Will laser vision correction eliminate my need for distance and reading glasses?

A: Laser procedures are very effective in correcting myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. These disorders are a result of a corneal curvature that is either too steep or too flat for the length of the eye. Vision is improved when the laser reshapes the curvature of the cornea. After reaching the age of forty most people experience a decline in the quality of their reading vision. This problem is age related and is due to a weakness of the focusing mechanism of the lens of the eye. Although laser vision correction cannot directly correct this problem, LASIK can give good distance and reading vision to many patients by readjusting the focus of their eyes. During your consultation, we will let you experience what you can expect after your procedure.

Q: If I have LASIK and my vision changes later in life, what can be done?

A: Once you eyes have stabilized after surgery, the correction is permanent. In the rare event that your vision does change, re-treatment is a possible option. We would perform a thorough examination and ensure adequate corneal thickness is present before any further correction.

Q: Are there any long-term side effect of LASIK?

A: Over 17 million people, including Dr. Lin, have had LASIK over the last 20 years. Refractive surgeons have been performing a similar procedure for over 50 years, a procedure known as automated lamellar keratoplasty (ALK). There have been a few reports of the cornea becoming unstable years after the procedure is performed. These cases are very rare, and occur mostly in cases where the stromal bed is below 250 microns (0.25mm). When I perform the LASIK procedure, I measure the corneal thickness during the surgery to ensure that we leave at least 280 microns in the stromal bed. With the MICRO-LASIK thin flap LASIK technique we often have more than 360 microns in the stromal bed. We can discuss this and any other concerns you may have at your consultation.

Q: How long does the eye take to heal after surgery?

A: The cornea is about 90% healed in the first 24 hours after the LASIK procedure. You can resume full activity after two weeks. However, there will be continuous healing for 3-6 months.

Q: Will I have perfect 20/20 vision after having LASIK?

A: This depends on your best correctable visual acuity. Some of our patients achieve better than 20/20 vision! Most patients achieve their full desired visual acuity. If the desired visual acuity is not achieved, an enhancement procedure is usually performed three months after the initial procedure.

Q: What will I see during the procedure?

A: During the procedure, we will ask you to focus on a blurry, blinking red light. Immediately after the procedure the red light should become much clearer, and you should notice an improvement in your vision.

Q: I am very concerned about being able to remain still during the procedure?

A: This is a common fear many patients have. Since every patient moves during the procedure, the laser treatment is designed to stop instantly if necessary. Our lasers, the Alcon Nidek EC-5000 and the Alegretto WaveLight Eye-Q 400Hz, have eye trackers that will follow your eye during the procedure. The laser delivers the pulses wherever they are supposed to go, despite any eye movements.

Q: What if I blink during the procedure?

A: To minimize blinking, your eye will be numbed by an aesthetic. Even if you blink, the eye is held open by a small device called speculum, a minimal discomfort, and the Eye Tracker will still track your eyes to ensure proper laser placement.

Q: Will I need to wear anything over my eye(s) after the procedure?

A: Patients will wear a clear shield immediately after the procedure and during sleeping hours.

Q: Will I have any scars?

A: The minimal scarring that occurs will be out of the visual axis (will not affect vision) and can only be seen with a microscope.

Q: In the event that I am not fully corrected, can I still wear contact lenses?

A: Yes, in almost all cases, you will be able to wear contacts after the procedure. However, it is rare for patients to wear contact lenses, except cosmetic colored contact lenses.

Q: Who is a good candidate for LASIK?

A: In general, patients who see well with glasses or contact lenses, have healthy eyes and are in good health are good candidates for laser vision correction. Whether or not you should undergo the procedure is a decision that should be made after a comprehensive exam by a skilled ophthalmologist who specializes in laser vision correction. Our exams are part of a no-cost consultation that will allow the patient and surgeon to discuss all options available such as LASIK, Micro-LASIK, LASEK, Intacs, LRI, or ICL.

Q: Is LASIK safe?

A: Laser vision correction is very safe, when performed by a skilled surgeon. Dr. Lin, himself, had LASIK over 15 years ago. He has performed over 40,000 refractive procedures, and has performed MICRO-LASIK® on his parents, and two brothers, one who is a doctor, and the other a lawyer. Dr. Robert Lin is a nationally known, and well-respected surgeon who operates with his patients’ safety as the top priority. Most complications can be treated with eye drops or a repeat procedure. More serious complications are rare because the procedure is limited to the front surface of the eye and not in the eye itself. There have been no reports of blindness caused by LASIK and none of Dr. Lin’s patients have lost significant vision. Without glasses or contacts lenses all of Dr. Lin’s patients have had improved near or distant vision. Dr. Lin and our staff will thoroughly discuss any risks and benefits before the surgery.

Q: What takes place during a complimentary consultation at IQ Laser Vision?

A: At the FREE consultation, we will gather data about your eyes including: visual acuity, refraction, measurement of current glasses, biomicroscopy, infrared pupillometry (measurement of nighttime pupil size), pachymetry (measurement of corneal thickness), corneal topography (using up to 3 different systems to measure both anterior and posterior surfaces), and if applicable, wavefront analysis. Based on these findings, our surgeon, Dr. Robert Lin will select the best treatment for your eyes. He will take as much time as necessary to thoroughly understand your expectations and explain the risks and benefits of the procedure.

Q: Does the Z-LASIK procedure take longer than the typical LASIK procedure?

A: No.  The procedure would take about the same amount of time.

Q: What is the femtosecond laser?

A: A femtosecond laser is a high-frequency laser, which uses ultra-short pulses of invisible light.  It is designed to gently separate the outer layers of the cornea, creating a customized flap for each patient, precisely, safely and painlessly.


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