Bladeless LASIK: What Is the Difference & Which Is Best?

If you are skittish when it comes to blades, knives, and sharp objects and considering LASIK surgery, you may find bladeless LASIK to be an attractive option. Bladeless LASIK involves the use of a femtosecond laser in lieu of a blade to create the corneal flap.

Bladeless LASIK is beneficial to patients looking to avoid some post-surgery complications. This type of LASIK can potentially reduce the likelihood of experiencing complications during and after the LASIK procedure.

What Is Bladeless LASIK?

Traditional LASIK utilizes an automated blade in lieu of a scalpel. LASIK is a highly accurate and precise procedure, so the use of a blade does not mean it is unsafe. However, bladeless LASIK is said to be even safer and more accurate than traditional LASIK surgery.

Bladeless LASIK is an all-laser procedure, while traditional LASIK incorporates a blade to create an incision in the cornea (also called a corneal flap).

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Bladeless vs. Traditional LASIK

During either type of LASIK procedure, an eye surgeon makes an incision, creating a hinged flap in the cornea in the process. This flap can then be positioned to allow the cornea to be reshaped, which helps to improve vision. After surgery, the corneal flap is returned to its normal position.

Traditional LASIK procedures use a blade (called a microkeratome). Conversely, bladeless LASIK uses an additional laser to create the incision and corneal flap.

It is important to protect your eyes after either type of LASIK. Any sort of contact, either from scratching the eye or a hit by an object or person, can result in damage and/or infection. Take care to follow your surgeon’s aftercare instructions carefully to promote healing.

How Bladeless LASIK Works

The bladeless LASIK procedure can be performed in less than 30 minutes. Like traditional LASIK, it generally takes less than 10 minutes per eye. 

Patients will undergo an initial examination to determine candidacy for LASIK.

During the procedure, a doctor will clean and numb the area. The eyelid is held open with an instrument called a lid speculum to prevent blinking or movement.

The cornea is then flattened with a plastic plate. After this, laser energy is focused on the corneal tissue. This laser energy generates water and small bubbles of gas, which separates the stroma and creates the corneal flap.

After exposing the underlying tissue, the eye surgeon then vaporizes precise amounts of corneal tissue according to measurements taken during the initial evaluation. When the procedure is concluded, the flap is returned to its normal position. 

After surgery, a shield may be worn to protect the eyes. Most people are able to resume normal activities the day following surgery.

Benefits of Bladeless LASIK

Individuals often choose bladeless LASIK out of a simple desire to avoid use of a blade during treatment. There are also a number of additional benefits that bladeless LASIK provides, such as these:

Lower Risk of Complications

Bladeless LASIK provides increased precision, which results in a lower risk of experiencing complications during and after surgery. This form of LASIK reduces the likelihood of experiencing the following additional unwanted side effects:

• Diffuse lamellar keratitis (inflammation around the corneal flap)
• Flap striae (folds around the flap)
• Epithelial growth (into the corneal flap area)
• Eye infection

Better Treatment Profile

Individuals who have severe vision problems, such as high levels of nearsightedness, can be treated with bladeless LASIK due to higher precision levels. 

Femtosecond lasers used during bladeless LASIK create corneal flaps of extremely precise thickness, increasing the likelihood of success and patient satisfaction.

Faster Healing Time

Bladeless LASIK improves upon the already fast healing and recovery time that traditional LASIK procedures offer. 

This form of LASIK promotes faster healing by creating corneal flaps that fit back into place more precisely than traditional LASIK surgery. This reduces the risk of corneal damage and sets the table for a faster recovery.

Disadvantages of Bladeless LASIK

There are only a few disadvantages to bladeless LASIK. Patients may experience a sensitivity to light that patients who undergo traditional LASIK treatment are less likely to experience. 

The cost of bladeless LASIK is often higher than traditional LASIK since bladeless LASIK is an all-laser procedure.

Bladeless LASIK Candidacy

Not everyone will be a candidate for bladeless LASIK. Just like with traditional LASIK, thin corneas may exclude you from the procedure.

As with standard LASIK, it’s important to have a good health profile and a stable vision prescription for one to two years. Those who have an unstable prescription will not be a good candidate for LASIK. Eye care professionals recommend pursuing either form of LASIK only when vision has stabilized.

Those who have frequent eye infections and certain autoimmune disorders will generally not be good candidates for bladeless LASIK.

It’s important to consult with an ophthalmologist and an eye surgeon who has extensive experience with bladeless LASIK in order to determine candidacy for the procedure.

References

1. Comparison of Clinical Outcomes of LASIK, Trans-PRK, and SMILE for Correction of Myopia. (February 2022). Journal of the Chinese Medical Association.

2. Short Term Changes in Corneal Stress-Strain Index and Other Corneal Biomechanical Parameters Post-Laser in Situ Keratomileusis. (October 2021). Indian Journal of Ophthalmology.

3. Golden Goose Award Honors 11 Researchers for Unusual Discoveries that Greatly Benefit Society. (September 2022). American Association for the Advancement of Science.

4. A Randomized–Controlled Study of Bladeless and Microkeratome LASIK. (May 2006). Investigative Ophthalmology and Visual Science.