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Bladeless Lasik - iLasik

Detailed comparison to traditional Lasik.

Click to see video of Bladeless Lasik.  
The femtosecond laser creates a series of bubbles within the cornea that when combined make the Lasik flap. Click for video.  

Bladeless Lasik, also called "iLASIK or Bladeless Lasik, is exactly like traditional conventional or custom wavefront Lasik, except the corneal flap is created with a femtosecond laser microkeratome rather than a mechanical microkeratome with a metal blade.

Conventional or Wavefront

Bladeless/Bladeless Lasik may be performed with conventional laser ablation or wavefront-guided custom Lasik laser ablation.

Potential Advantage

There are several advantages to Bladeless/Bladeless Lasik that can make Lasik more predictable and safer than traditional Lasik with a mechanical microkeratome, however there are limitations and a unique set of concerns that need to be evaluated.

Advantages include more precise positioning of the flap, more accurate thickness of the flap, more even thickness of the flap throughout, and a lower probability of intraoperative complications such as buttonhole flaps, thin/thick flaps, or epithelial defect. Recent studies have shown Bladeless/Bladeless Lasik to be more favorable than Lasik with a mechanical microkeratome in providing vision with better contrast sensitivity.

Potential Disadvantage

Some patients, but not all, experience a short period of increased corneal edema with Bladeless/Bladeless Lasik. This slight swelling can cause vision to be blurry, but the swelling normally resolves with healing. Occasionally an Bladeless/Bladeless Lasik patient will experience some photosensitivity. All these issues usually resolve during the normal Lasik healing process, however additional eye drop medication may be required.

Occasionally Required

Bladeless/Bladeless Lasik is an option for nearly all who decide to have refractive surgery with a corneal flap, but Bladeless/Bladeless Lasik may be a requirement for individuals with preexisting epithelial defects, large pupils, thin corneas, poor contrast sensitivity, or other physiological reasons that indicate the greater accuracy and safety of Bladeless/Bladeless Lasik is required.

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

Personalized Answers

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.

Recent Femtosecond Laser Medical Journal Articles...

Related Articles

[Corneal subbasal nerve density changes after laser in situ keratomileusis with mechanical microkeratome and femtosecond laser].

Zhonghua Yan Ke Za Zhi. 2015 Jan;51(1):39-44

Authors: Hu L, Xie W, Tang L, Chen J, Zhang D, Yu P, Qu J

OBJECTIVE: To compare the corneal subbasal nerve density (SND) changes after laser in situ keratomileusis (LASIK) with a microkeratome and a femtosecond laser.
METHODS: Prospective clinical study. Sixty eyes of thirty myopes were included. Fifteen patients (30 eyes) underwent LASIK with the Moria II microkeratome, and the other 15 patients (30 eyes) with the 60 k Hz IntraLase femtosecond laser. Central, temporal and nasal corneal SNDs were measured by confocal microscopy and compared before surgery, 1 month, and 3 months after surgery. Analysis of variance and t test were used for comparing the differences between different time points and two groups.
RESULTS: Preoperatively and 1 month, 3 months postoperatively, the SNDs were (16 728.30 ± 4 300.30), (1 875.42 ± 300.50) and (1 701.55 ± 194.11) µm/mm(2) in the central cornea, (11 379.70 ± 1 833.92), (1 341.20 ± 288.68) and (1 860.87 ± 147.60) µm/mm(2) in the temporal cornea, and (8 506.79 ± 662.83), (7 428.96 ± 712.99) and (8 044.32 ± 1 077.54) µm/mm(2) in the nasal cornea, respectively, in the microkeratome group, and (16 351.59 ± 3 503.88), (1 859.38 ± 452.93) and (2 043.67 ± 377.76) in the central cornea, (12 328.22 ± 2 007.43), (1 483.85 ± 371.28) and (2 126.31 ± 279.87) µm/mm(2) in the temporal cornea, and (8 347.91 ± 789.44), (1 475.53 ± 293.98) and (2 022.10 ± 282.89) µm/mm(2) in the nasal cornea, respectively, in the femtosecond laser group. The SNDs at three positions all decreased significantly at each time point postoperatively compared to the baseline values in both groups (1 and 3 months in the microkeratome group: central t = 18.981 and 18.912, temporal t = 30.121 and 27.921, and nasal t = 6.456 and 2.126; in the femtosecond laser group: central t = 22.667 and 22.379, temporal t = 29.000 and 28.376, and nasal t = 46.329 and 41.751; all P < 0.01, except 3 months at the nasal in the microkeratome group, P = 0.042). The nasal SND increased significantly from month 1 to month 3 (t = -3.921, P < 0.01) in the microkeratome group, and the temporal and nasal SNDs both increased significantly from month 1 to month 3 (t = -9.629 and -6.645, both P < 0.01) in the femtosecond group. There were no significant differences in the central SND between the two groups (F = 0.002, P = 0.96). Significant differences were found in the nasal SND between the groups at 1 month and 3 months (t = 42.281 and 29.608, both P < 0.01), and in the temporal SND at 3 months after surgery (t = -4.595, P < 0.01).
CONCLUSIONS: Peripheral corneal nerve recovery occurred at 1 month after LASIK surgery. Patients with a femtosecond laser showed better corneal regeneration than those with a microkeratome.

PMID: 25877709 [PubMed - in process]


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