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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

Comparison of the femtosecond laser and mechanical microkeratome for flap cutting in LASIK.

Int J Ophthalmol. 2015;8(4):784-90

Authors: Xia LK, Yu J, Chai GR, Wang D, Li Y

AIM: To compare refractive results, higher-order aberrations (HOAs), contrast sensitivity and dry eye after laser in situ keratomileusis (LASIK) performed with a femtosecond laser versus a mechanical microkeratome for myopia and astigmatism.
METHODS: In this prospective, non-randomized study, 120 eyes with myopia received a LASIK surgery with the VisuMax femtosecond laser for flap cutting, and 120 eyes received a conventional LASIK surgery with a mechanical microkeratome. Flap thickness, visual acuity, manifest refraction, contrast sensitivity function (CSF) curves, HOAs and dry-eye were measured at 1wk; 1, 3, 6mo after surgery.
RESULTS: At 6mo postoperatively, the mean central flap thickness in femtosecond laser procedure was 113.05±5.89 µm (attempted thickness 110 µm), and 148.36±21.24 µm (attempted thickness 140 µm) in mechanical microkeratome procedure. An uncorrected distance visual acuity (UDVA) of 4.9 or better was obtained in more than 98% of eyes treated by both methods, a gain in logMAR lines of corrected distance visual acuity (CDVA) occurred in more than 70% of eyes treated by both methods, and no eye lost ≥1 lines of CDVA in both groups. The difference of the mean UDVA and CDVA between two groups at any time post-surgery were not statistically significant (P>0.05). The postoperative changes of spherical equivalent occurred markedly during the first month in both groups. The total root mean square values of HOAs and spherical aberrations in the femtosecond treated eyes were markedly less than those in the microkeratome treated eyes during 6mo visit after surgery (P<0.01). The CSF values of the femtosecond treated eyes were also higher than those of the microkeratome treated eyes at all space frequency (P<0.01). The mean ocular surface disease index scores in both groups were increased at 1wk, and recovered to preoperative level at 1mo after surgery. The mean tear breakup time (TBUT) of the femtosecond treated eyes were markedly longer than those of the microkeratome treated eyes at postoperative 1, 3mo (P<0.01).
CONCLUSION: Both the femtosecond laser and the mechanical microkeratome for LASIK flap cutting are safe and effective to correct myopia, with no statistically significant difference in the UDVA, CDVA during 6mo follow-up. Refractive results remained stable after 1mo post-operation for both groups. The femtosecond laser may have advantages over the microkeratome in the flap thickness predictability, fewer induced HOAs, better CSF, and longer TBUT.

PMID: 26309880 [PubMed]


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