Blade vs. Bladeless Lasik Surgery: Which Is Right For You?

Blade vs. Bladeless Lasik Surgery Is blade or traditional LASIK or bladeless IntraLase surgery the best procedure to correct your vision? Consumers interested in LASIK procedures have a responsibility to learn as much as possible about each procedure, so they can optimize their results and select a procedure most likely to produce positive results.

Many of the studies available on blade and bladeless surgery are conflicting, suggesting both LASIK and IntraLase (bladeless) procedures produce similar outcomes. Let's explore some of these outcomes so you have a better understanding of each procedure.

Traditional LASIK
Traditional LASIK surgery uses a blade. This surgery requires the surgeon use a microkeratome to cut the thin, hinged flap common to LASIK surgeries. This instrument, the microkeratome, may be considered a blade. Once the surgeon cuts a hinge of the cornea, he or she can then lift this and apply a special laser to correct vision problems.

After a surgeon lasers the cornea and reshapes the eye, the surgeon will replace the flap to encourage fast and easy healing.

Bladeless Surgery
Newer technology has allowed surgeons to adopt newer strategies. The IntraLase LASIK procedure involves use of a femtosecond laser rather than a blade (or the microkeratome) to cut a thin flap in the cornea for surgery. Sometimes patients and doctor's alike refer to this as an "all laser" rather than a bladeless procedure.

LASIK Pros and Cons
There is much debate among eye surgeons about what form of surgery is best for patients. Patients should learn all they can about each procedure before deciding the best choice for them. Many times a surgeon simply prefers one surgery to another for personal reasons.

Traditional LASIK serves most patients who need minor vision corrections well. Some surgeons prefer using the microkeratome to create the corneal flap because they believe the procedure is much quicker and a bit more comfortable for patients. Typically a microkeratome will create a precise corneal flap in just a few seconds. The IntraLase procedure requires a bit more time, but still takes less than a minute. Still others believe there is more risk of corneal flap problems associated with traditional LASIK surgery, thus recommend a bladeless alternative for patients.

IntraLase Pros and Cons
The bladeless procedure uses only lasers to correct vision. This is an advantage for some but not others. Some surgeons suggest there is less risk for complications including unattached or partial flaps or improperly formed flaps when a laser is used to create the corneal flap compared with the microkeratome.

There is less risk for the patients many believe even if the procedure is not as swift as traditional LASIK (though the difference in time is slight). One of the more common complications with traditional LASIK surgery, the buttonhole flap, is almost non-existent when a surgeon uses IntraLase. A buttonhole flap is a corneal flap shaped like a buttonhole, an undesirable outcome.

How To Select The Right Procedure
The use of IntraLase vs. traditional LASIK is largely a matter of preference for many surgeons. Most surgeons agree the skill and experience of the surgeon has as much to do with the outcome of surgery as the actual tool used.

Modern microkeratomes can help create precise corneal flaps when used correctly. The data suggesting there are more risks associated with use of the microkeratome is controversial, with some data suggesting more disadvantages for patients using the blade to create a flap. Patients should know there are advantages and disadvantages to each. For example, when using the IntraLase, a surgeon should tell patients there is more risk for swelling resulting from the extra laser energy used to create a flap.

What is important is you talk with your surgeon about the advantages and disadvantages of blade vs. bladeless procedures.

Below you will find a summary of the advantages and disadvantages of the blade vs. the bladeless LASIK procedures.

Traditional LASIK IntraLase Bladeless LASIK

Microkeratome creates corneal flap faster than the bladeless procedure.

Microkeratome creates corneal flap faster than the bladeless procedure.

Microkeratome used to create flap makes a flap thinner at center and a bit thicker along the edge.

There may be a higher rate of higher order aberrations or visual distortions from use of the blade to create a corneal flap.

Better for patients who have had previous surgery and experienced complications.

Use of microkeratome to create flap better for patients with glaucoma.

   IntraLase Bladeless LASIK

Less risk for buttonhole flaps when using bladeless procedure.

Bladeless flap created with a laser creates a more uniform flap.

IntraLase presents a unique risk of developing light sensitivity under certain situations.

IntraLase is more expensive than the LASIK blade procedure.

Some surgeons believe the longer-term outcomes for patient's undergoing the bladeless procedure may be better.

Many studies suggest the risks of each surgery are comparable, and the outcomes for patient's receiving either blade or bladeless surgery are similar. Again, a large part of the outcome depends on the skill of the surgeon using the equipment and the patient's individual medical history.

It is important again that you weigh the benefits and risks of either surgery before deciding whether blade or bladeless laser surgery is best for correcting your vision.

When you had your Lasik surgery did you choose blade or bladeless? Which one and why? Let us know in the comment box below.

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