• Blade vs Bladeless LASIK Surgery

Blade vs Bladeless LASIK Surgery

If you’re think­ing about LASIK, you might not have known it can be done with and with­out a sur­gi­cal blade.

LASIK (an acronym for Laser Assist­ed In Situ Ker­atomileu­sis) was first used in the U.S. in 1991 and has been updat­ed pret­ty reg­u­lar­ly with new laser tech­nolo­gies. The pro­ce­dure com­mon­ly mar­ket­ed as blade­less LASIK came in 2007, intro­duced as IntraLase.

Isn’t All LASIK Bladeless LASIK?

New­er LASIK pro­ce­dures are blade­less, although some eye sur­geons bris­tle at the term “blade­less” since all LASIK pro­ce­dures cut into the eye sur­face. The ear­li­est pro­ce­dure, which is still safe­ly per­formed today with very few com­pli­ca­tions, uses a spe­cial­ized blade.

First, a lit­tle back­ground. Myopia (near­sight­ed­ness) and far­sight­ed­ness hap­pen when var­i­ous parts of the eye change shape and inter­fere with prop­er vision. In near­sight­ed­ness, the eye­ball becomes elon­gat­ed, dis­rupt­ing the way the cornea or lens fit on it. Or some­times they curve on their own and dis­rupt the con­for­mi­ty. These changes are often genet­ic and begin to appear in young adult­hood.

Far­sight­ed­ness (hyper­opia) occurs when the eye­ball is too short and the eye focus­es on images behind the reti­na instead of on it. It can dis­rupt vision at any dis­tance. All LASIK pro­ce­dures fix these prob­lems by reshap­ing the eye, which involves cut­ting into the sur­face to cre­ate a very thin flap.

Tra­di­tion­al LASIK cre­ates the flap with a sur­gi­cal blade called a micro­ker­atome. The new­er LASIK pro­ce­dures approved since 1999 use dif­fer­ent types of lasers to cut into the eye, cre­at­ing the “LASIK flap.”

That’s essen­tial­ly the dif­fer­ence in all LASIK surgery pro­ce­dures. After the flap is cre­at­ed, the sur­geon lifts it and directs a laser under­neath it to lit­er­al­ly reshape the eye to cor­rect the vision. The flap is put back down and allowed to heal, which takes a week or less.

Is Bladeless LASIK Eye Surgery Safest for Patients?

Because each patient’s eyes are dif­fer­ent, it’s best to go with the surgeon’s opin­ion when it comes to decid­ing which kind of LASIK surgery to have. Many sur­geons use dif­fer­ent tech­niques, tak­ing into con­sid­er­a­tion com­pli­ca­tions like glau­co­ma and pre­vi­ous eye surg­eries.

As for safe­ty, the real fac­tor is the surgeon’s skill but over­all LASIK is among the safest surg­eries. Both laser and micro­ker­atome cut­ting car­ry cer­tain risks and ben­e­fits.

Microkeratome — Blade vs Bladeless  LASIK:

Microkeratome-created flaps:

  • Very low risk for detached flaps and oth­er com­pli­ca­tions
  • Pos­si­ble high­er risks for “but­ton­holes” in flaps
  • High­er risk for vari­a­tion in flap thick­ness
  • Bet­ter for patients with glau­co­ma
  • Bet­ter for repair­ing pre­vi­ous LASIK errors
  • Takes less time to per­form
  • Requires less suc­tion, which can be painful for patients

Laser-created flaps:

  • Increased risk for ede­ma (swelling) on the flap that can length­en recov­ery time
  • Low­est risk for flap com­pli­ca­tions
  • No vari­a­tion in flap thick­ness
  • Tem­po­rary light sen­si­tiv­i­ty
  • More expen­sive
  • Bet­ter post-surgery vision
  • Rarely requires sub­se­quent “touch up” surgery

Laser-created flaps

Is Bladeless Lasik Less Painful Than Traditional LASIK?

Hon­est­ly, LASIK surgery is pret­ty low on the pain scale, espe­cial­ly com­pared to oth­er surg­eries you may have had, such as appen­dec­to­my or chole­cys­tec­to­my (gall­blad­der removal).

Your sur­geon will numb your eyes with drops, and there is lit­tle actu­al pain after the pro­ce­dure. Many patients feel like there’s some­thing float­ing around in their eyes, and tear­ing is pret­ty com­mon. There may be a lit­tle bit of burn­ing or itch­ing while the cornea heals, but noth­ing approach­ing actu­al pain.

Per­fect, or near-per­fect eye­sight is a gift. If you have pret­ty bad eye­sight and are tired of wear­ing glass­es or con­tact lens­es, you should con­sid­er LASIK. Con­tact us for a free con­sul­ta­tion, today!

December 11th, 2018|Comments Off on Blade vs Bladeless LASIK Surgery

About the Author:

Born in Connecticut and raised in Upstate New York , Dr. Stetson graduated Cum Laude from Colgate University in New York, and then earned an MD degree with honors at the University of Vermont College of Medicine. He distinguished himself again in residency at the Albany Medical Center, where he obtained the highest percentile in the Ophthalmology Knowledge Assessment Examinations. Dr. Stetson has performed more than 50,000 refractive surgeries and has been on staff at Diamond Vision since 2004, before becoming Medical Director in 2006.


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