Advantages of bladeless LASIK

Friday, January 1st, 2010 at 3:26 am Post in Vision Surgery

While conventional LASIK uses mechanical cutting tools, all-laser LASIK performs in a different way. Also named bladeless LASIK, all-laser LASIK takes use of two types of lasers: femtosecond laser and excimer laser. These two types of lasers can both reshape the cornea and improve focus ability.

Within each of the two types of lasers used in bladeless LASIK, there are different brands. While IntraLase laser belongs to femtosecond laser, it can also be combined with other excimer lasers with FDA approval. Systems of bladeless LASIK include iLASIK, zLASIK, Femtec and VisuMax. During a bladeless LASIK, computer software is used to guide the femtosecond laser beam, creating a corneal flap with a precise depth.

Both blade and bladeless LASIK procedures may bring complications at low incidence. Complications associated with metal blade surgeries can be uneven flap edges, which cause abnormal corneal surfaces and vision defects. Blades may also create vision-threatening scars, which are rare in bladeless LASIKs. Bladeless LASIK creates flaps using infrared laser energy. Femtosecond laser performs at very high speeds and divides tissues at a molecular level. Studies show that all-laser LASIK is much less likely to bring overall complications, while there are still two forms of complications. Light sensitivity and rainbow effect are those two common complications associated with bladeless LASIK.

With lower risk of complications, bladeless LASIK costs about $300 more every year. There has been long a debate between blade and bladeless. Many people still opt to choose blade LASIK, but bladeless LASIK is gaining popularity among surgeons. Some surveys reveal that there are already more than 30% of surgeons who prefer bladeless to blade.

In the past, people with thin corneas are considered to be unsuitable for LASIK. However, this situation has been changed with the help of bladeless LASIK. Thinner flaps on the corneal surfaces are able to create better effects and less possibility of complications. While most blade LASIKs cut flaps with thickness between 140 and 180 microns, femtosecond lasers can create flaps as thin as 100 microns. In this way, bladeless LASIK is capable of curing patients with thin corneas. Besides bladeless LASIK, PRK is also suitable for people with thin corneas.

Bladeless LASIK has other advantages over blade LASIK. By creating more defined, angled edges, bladeless LASIK may cause fewer LASIK complications. The flap created by femtosecond lasers is more accurate and adjustable. Rather than round flaps of blade LASIK, bladeless LASIK creates oval flaps that are better to match the cornea. Bladeless LASIK also brings flap in different structure and architecture, which improve flap adherence and stability.

As mentioned before, complications such as buttonholed or partially formed flaps can be avoided by bladeless LASIK. Bladeless flap also brings down the risk of developing eye infection or contamination during the procedure. During the short flap creation process, patients may experience temporary eye redness, which is harmless and inevitable. There are still different opinions about the application of bladeless LASIK following a first RK surgery.

Bladeless LASIK has also been proved to sharpen vision after a refractive lens exchange, although more studies are needed. Some people may get eye irritation after a bladeless LASIK, but the risk of post-operative dry eye is lower than traditional LASIK.