Patients considering LASIK eye surgery may come across medical jargon, such as "blade" and "bladeless" LASIK. To a layman, such terms might appear overwhelming. However, as a patient you must know the difference between the two surgery types, and the rewards and risks associated with each.
Traditional LASIK makes use of a microkeratome to cut a thin hinged flap in the cornea. The flap is then folded back to reveal the stroma - the middle layer of the cornea. A high precision laser, called the excimer laser, is used to reshape the corneal surface so as to correct any refractive error. The flap is then repositioned to act as a natural bandage. Since the microkeratome used to create a flap is in fact a surgical blade, the procedure is also known as blade, the procedure is also known as blade LASIK.
A more recent innovation, introduced in 1999, makes use of a high energy laser (IntraLase or femtosecond laser) to create a flap during surgery. As opposed to traditional LASIK, IntraLase does not employ a surgical blade, and hence the procedure is often marketed as "bladeless" or "all laser" LASIK. The term itself has raged a debate among eye surgeons, as to whether it should be used in IntraLase advertisements or not. Several surgeons assert that the term "bladeless" implies that traditional LASIK, which makes use of a surgical blade (microkeratome), is a scarier proposition, when in fact it's not. The creation of the flap is an important part of the laser eye surgery procedure. It's true that flap predictability is better with a laser flap, that is, with bladeless LASIK.
Moreover, there is a reduced possibility of flap complications, such as partial flaps, flap dislocation, free flaps etc.
However, an expert surgeon wielding a contemporary microkeratomecan very well match the finesse of bladeless LASIK. Although the chances are rare, there is an issue of transient light sensitivity as well - a unique risk associated with bladeless LASIK.
Moreover, the bladeless LASIK procedure costs an extra $300 per eye, when compared with traditional LASIK. All said and done, LASIK itself is one of the safest refractive surgery procedure.
Whether it's blade or bladeless, it largely depends on the eye surgeon of your choice. If the surgeon has loads of experience carrying out microkeratome procedures, it's better to have it that way. If otherwise, you may go in for the relatively new bladeless LASIK surgery.
Nicola Kennedy publishes articles and reports and provides news and views about blade and bladeless LASIK at Your Lasik Information.
1 comment:
I had lasik done in July. My vision is 20 /30, however, I can only see well (clear, crisp) when I am outside, and it is a sunny day. Once I step inside the house or inside a building, my vision is blurry and to the point where I can't even read without good lighting. As far as night vision, I can't see cleary at all. I have to drop Alphagan to help my pupils become smaller just to be able to see a little better while driving in the morning, since the mornings are starting to get darker outside. My doctor says it will take 3-6 months for my eyes to heal because my vision was so bad prior to the surgery. I was at -9 in both eyes. In addition, I have pretty big pupil size. Will this contrast in vision in good lighting and low lighting eventually go away? Can a enhancement correct this problem? Sept 30 will be 3 months after my lasik surgery.
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