Bench-to-Bedside: IntraLase

1. The discovery of IntraLase allowed surgeons to use a laser in place of the blade typically used to cut a flap in the cornea for LA SIK surgery. The flap is created by focusing a stream of ultra-short light pulses—about 60,000 pulses per second—onto the cornea.

2. The IntraLase laser beam moves back and forth until a uniform layer of microscopic bubbles forms just below the corneal surface. Thousands of these bubbles, made of carbon dioxide and water, are placed at a specified depth and result in an exceptionally precise “cut.” The flap is created by gently separating the tissue where these bubbles have formed. Creation of the flap takes about 15 seconds.

3. After the flap is lifted, an excimer laser is used to complete the vision correction procedure by sculpting the corneal surface and changing its contour.

An industrial accident gives a UMHS resident an idea for a better eye surgery

The Concept

In 1992, Ron Kurtz, M.D., a resident at the Kellogg Eye Center, treated a School of Engineering graduate student who came to the Retina Clinic with an eye injury. The patient was testing an ultrafast laser for industrial use and it had burned his eye. Kurtz noticed the laser burn created an extremely clean, precise cut on the retina, with very little damage to nearby tissue.

Collaboration produces proof of concept

In 1995, Kurtz, Paul Lichter, M.D., chair of Ophthalmology at that time, and Gerard Mourou, Ph.D., professor of electrical engineering, formed the Ultrafast Laser Medical Laboratory at the Center for Ultrafast Optical Science. The lab brought together doctors and engineers to explore development of the ultrafast laser for use in eye surgeries that traditionally required a surgical blade or knife.

Commercialization and FDA approval

In 1997, Kurtz and U-M physicist Tibor Juhasz, Ph.D., formed IntraLase Corp. to commercialize the ultrafast laser for corneal flap cutting. The U-M Office of Technology Transfer helped with the patent and licensing agreement, thus signaling the end of the University’s involvement in IntraLase business matters. The first human clinical trials were performed in early 1999, and later that year the FDA approved the corneal flap cutting product. The IntraLase FS laser was introduced to the U.S. market for LASIK surgery in 2001. Today, U-M physicians are investigating new surgical uses for the IntraLase FS laser, this time for corneal transplants and glaucoma surgery.

In Practice: A Patient's Perspective on LASIK

LASIK is a vision-correcting surgery that reshapes the cornea, resulting in clearer vision and freedom from or reduced dependence on glasses for many people. The ultrafast laser is used to make a flap in the cornea. Noelle Kirouac, B.S.N., R.N., Women’s Birth Center, had LASIK surgery at the Kellogg Eye Center in January, though she readily admits she always hated the idea of eye surgery.

“After reading everything I could find on LASIK, and after talking to the nurses, technicians and doctors at Kellogg who were so calm and reassuring, I knew it was time to say good-bye to contact lenses.” Part of Kirouac’s pre-operative education included information about the IntraLase FS laser and she asked her ophthalmologist Shahzad Mian, M.D., to use it.

“This was the best thing I’ve ever done,” she says. “The next day I had 20/15 vision. Now I can read the alarm clock at night without squinting, and my eyes aren’t tired at the end of the day from wearing contacts.”