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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

Early changes in ocular surface and tear inflammatory mediators after small-incision lenticule extraction and femtosecond laser-assisted laser in situ keratomileusis.

PLoS One. 2014;9(9):e107370

Authors: Gao S, Li S, Liu L, Wang Y, Ding H, Li L, Zhong X

PURPOSE: To characterize the early ocular-surface changes or tear inflammatory-mediators levels following small-incision lenticule extraction (ReLEx smile) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK).
METHODS: Forty-seven myopic subjects were recruited for this prospective study. Fifteen underwent ReLEx smile and thirty-two underwent FS-LASIK. Corneal fluorescein (FL) staining, tear break-up time (TBUT), Schirmer I test (SIT), ocular surface disease index (OSDI) and central corneal sensitivity were evaluated in all participants. Tears were collected and analyzed for interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), nerve growth factor (NGF) and intercellular adhesion molecule-1 (ICAM-1) levels using multiplex magnetic beads. All measurements were preformed preoperatively and 1 day, 1 week, 1 month and 3 months postoperatively.
RESULTS: FL scores in ReLEx smile group were lower than those of FS-LASIK group 1 week postoperatively (P = 0.010). Compared to the FS-LASIK group, longer TBUT were observed in ReLEx smile group 1 month (P = 0.029) and 3 months (P = 0.045) postoperatively. No significant differences were found in tear secretion for the two groups (P>0.05). OSDI scores were higher in FS-LASIK group 1 month after surgery (P = 0.020). Higher central corneal sensitivity was observed in ReLEx smile group 1 week, 1 month and 3 months (P<0.05) postoperatively. Compared to FS-LASIK group, lower and faster recovery of IL-6 and NGF levels in tears was observed in ReLEx smile group postoperatively (P<0.05). Tears TNF-α and ICAM-1 concentrations were not significantly different between the two groups at any follow-up time (P>0.05). Moreover, IL-6 and NGF levels correlated with ocular surface changes after ReLEx smile or FS-LASIK.
CONCLUSIONS: In the early postoperative period, ReLEx smile results in milder ocular surface changes than FS-LASIK. Furthermore, the tear inflammatory mediators IL-6 and NGF may play a crucial role in the ocular surface healing process following ReLEx smile and FS-LASIK.

PMID: 25211490 [PubMed - in process]


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