Lasik Vision Correction: Blade vs. Bladeless Techniques

One of the defining steps in Lasik vision correction is cutting the hinged corneal flap. This flap is what makes this procedure different from all the other laser eye surgery procedures.

Blade Technique

In traditional Lasik vision correction your eye surgeon uses a microkeratome knife to cut the corneal flap.

The flap is laid back, exposing the corneal tissue. Your surgeon shapes the cornea using the laser. When finished, he places the corneal flap back in place. This flap now acts as a bandage to cover the cornea during healing.

Many surgeons claim that the microkeratome knife can cut a more ragged edge than the laser keratome. Incisions that are ragged risk poor outcomes like halos and starbursts. Others prefer this method to a laser-cut flap.

If you have chosen a surgeon who is highly skilled in the use of the microkeratome this procedure might be as safe as the bladeless one. It could be less expensive, as well.

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While cost may be a concern, don’t trade the best results to save a few hundred dollars. If you’ve taken your time choosing a skilled eye surgeon, trust his recommendation. He knows which technique he does best, and which should give you the best outcomes.

As with any surgery, good outcomes can’t be guaranteed. Also, your surgeon can’t guarantee that you won’t experience any of the known risk

Bladeless Technique

Bladeless, or All-laser LASIK uses a laser keratome, instead of the microkeratome knife, to cut the corneal flap. Many surgeons claim that lasers cut more precise incisions, and that reduces the risk of unsatisfactory outcomes.

The higher quality edge created by the laser keratome heals better than the blade-cut edge. On the down side, the use of a laser to cut the corneal flap will probably increase the cost of your surgery.

Your Eye Surgeon Chooses the Procedure

Your surgeon knows which procedure he does best. His success rate will influence his decision. After he examines your eyes and does diagnostic tests and measurements he will know which procedure is better for you.

He knows the advantages and disadvantages of each procedure. He will consider your overall health, unique health and eye characteristics, and medical history. Your lifestyle, job, hobbies and activities are important, too.

Be sure to ask him what he takes into consideration when making his decision and recommendations. In general his concerns will probably include quality of vision, complication rate (his own and overall statistics), the amount of pain you are able to deal with, size and thickness of the flap, how long it will take for your vision to completely recover, and total expense.

How Do They Compare?

Traditional Lasik vision correction is a well-established procedure. It has a long history of successful results. And it is less expensive than bladeless procedures.

One drawback to the microkeratome knife-cut edge is that it doesn’t heal as well as the laser-cut edge. There are more incidents of post surgical halos and starbursts.

All-Laser LASIK is newer, using newer technology. Its history of success is not as long, but it appears to have slightly better statistics as the traditional procedure.

The flap cut by a laser is a higher quality precise edge, so it tends to heal better. These patients have a slightly lower incidence of halos and starbursts postoperatively.

The All-Laser method will be more expensive because it uses expensive technology and equipment.

Improving Your Likelihood of Getting the Best Results

You can do the most to improve your outcomes by choosing your eye surgeon carefully. When you make the right choice from the beginning, the rest will go as well as it possibly can. Just make sure the surgeon you select has at least 100 successful procedures to his credit. See our page on what to ask your eye surgeon to learn more.

Fewer than 5% of Lasik vision correction patients have problems. Most of these are resolved satisfactorily with a follow-up enhancement treatment.

Be aware, though, that no surgery is without risk. Even if your surgeon has had 100% satisfaction, there is always the possibility that you or another patient will not respond well to the procedure.

Talk with your surgeon before surgery to find out what his follow-up treatment policies are. And be prepared to deal with the outcome, whatever it is.


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