New Lasers Take Precision to Next Level for Wake Forest Baptist Health Ophthalmologists

Dr.Giegengack and laser equipment

The arrival of two new lasers gives the Wake Forest Baptist Health Eye Center the latest technology on the market to handle a range of eye health issues. 

From LASIK surgery to corneal transplants, the WaveLight Femtosecond and Allegretto Wave Excimer lasers give surgeons an edge when treating patients.

Dr. Keith Walter "It's quicker, more precise and it's really kind of the way of the future,'' says Keith Walter, MD, an ophthalmologist who has been doing LASIK surgeries for 15 years at Wake Forest Baptist Health.

"It's a huge leap forward,'' says Matt Giegengack, MD, an ophthalmologist with Wake Forest Baptist Health for five years who specializes in corneal transplants. "Any procedure that requires you to cut the cornea, this laser does it potentially better than a blade.''

Here's a quick look at what the lasers will mean for eye surgeries.


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LASIK can be used to fix nearsightedness, farsightedness and astigmatism. LASIK surgery involves two steps: cutting the cornea to make a flap (historically performed by a surgeon using a blade) and then reshaping the cornea using a laser. The new Femtosecond laser will make a perfect flap in two seconds once the machine is placed onto the eye, Walter says. And the Allegretto laser will properly reshape the cornea in just 15 seconds, half the time of the old laser. "It's just so much easier,'' he says. "LASIK has never been safer."


Many people who have their distance vision corrected with LASIK surgery wind up needing glasses for reading and other close work. PresbyLASIK is a surgical technique that allows correction of near vision as well as distance vision. Walter says the technique is effective in many patients between the ages of 45 and 65, which is the range that typically needs near-vision correction once the eye has been reshaped to correct distance vision. "If you just have standard LASIK for distance and you're over 45, you'll need glasses 100 percent of the time,'' he says. "With the PresbyLASIK you'll probably need them [just] 20 percent of the time. So that's pretty good."

Corneal Transplants

People who need corneal transplants have developed a scar on the cornea that makes their vision foggy. Traditionally, surgery has involved cutting the center circle of the patient's cornea and implanting a similar size one from a donor, stitching the new piece into place. Giegengack says the new Femtosecond laser is a big improvement, allowing for extremely precise cuts of the cornea in a way that allows the new piece to fit the patient's eye "sort of like a tongue and groove.'' The benefit of such a cut is that the eye wound "heals faster, stronger and with more regularity."


One in 3,000 people is affected by keratoconus, a degeneration of the cornea that causes it to become conical shaped, which can badly distort vision. Surgery to repair the cornea calls for plastic inserts, called Intacs, to be placed into channels made in the cornea. The inserts help to reshape the cornea so that vision improves. Giegengack says the Femtosecond laser will make very accurate channels for the Intacs, a process that previously was done by blade. Currently, Giegengack does about 10 Intacs surgeries a year. "I think with the laser making it better and safer, I will do a lot more," he says.

Lens Cataract Surgery

One other technique growing in recent years, Walter says, is premium lens cataract surgery. As people age, they develop cataracts, which is cloudiness of the lens in their eye. Ophthalmologists have long done surgery to remove the lens, replacing it with a synthetic lens, which restores vision. In recent years, however, a new "multifocal'' or "premium" lens has been developed that doesn't just restore vision, but makes distance corrections too. Although this surgery does not require the new lasers, Walter says it continues to grow in popularity.

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Last Updated: 06-27-2014
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