Definition: Blade-free Laser Assisted In-Situ Keratomileusis, or LASIK, is a refractive surgery procedure which uses the excimer laser, applied to the cornea under a thin flap of corneal tissue, to help which correct refractive error, decreasing or eliminating the need for glasses or contact lenses. With Blade-free LASIK, a laser is used for all portions of the procedure.
How Does LASIK Work?
LASIK surgery works by sculpting the cornea in a precise manner to correct refractive errorBy changing the corneal shape, light becomes focused on the retina, allowing clear vision. During LASIK surgery, a very thin flap is created on the front of the cornea. The flap is then folded back, and the laser applied to the underlying corneal tissue in a precise manner that can correct nearsightedness, farsightedness and/or astigmatism. The flap is then replaced, protecting the reshaped cornea underneath. This protective flap can be created in two ways. In the first, a very fine surgical steel blade, called a microkeratome is used to create the flap. With Blade-free LASIK, a laser beam is used to create the corneal flap. Several laser technologies can be used to create the Blade-free LASIK flap. One of the most common such lasers is the Intralase laser.
What is the advantage of Blade-free LASIK surgery?
Several clinical studies suggest that regardless of whether the LASIK flap is created with a blade (microkeratome) or created with a laser (Blade-free LASIK), the visual outcome is excellent. There does not seem to be a significant advantage of one way of cutting the flap versus the other in regards to the vision obtained after the surgery. However, Blade-free LASIK may offer a small advantage of safety over LASIK in which a blade is used the cut the flap. Very rarely, when a blade makes the flap, the flap can be made irregularly, having a tattered edge or perhaps a buttonhole in the center. This may occur if the blade (microkeratome) comes loose from the eye during its cutting pass. With a laser created flap in Blade-free LASIK, this risk of an irregular flap may be smaller. If the laser becomes detached from the eye during the cutting pass, unlike the blade, the laser can be reattached and the pass started over in most cases. As such, a portion of flap related complications may be avoided with the Blade-free LASIK technique. Regardless of which technology is used to make the flap, though, the risk of any problem with cutting the flap during the surgery is very small.
Who are candidates for Blade-free LASIK surgery?
Blade-free LASIK surgery helps correct the vision of people with myopia, hyperopia,and/or astigmatism. In fact, a large majority of people who wear glasses or contacts and suffer from such refractive errorsas these could be candidates for LASIK surgery other excimer laser refractive surgery such as PRK.
In general, candidates for Blade-free LASIK should be:
- 21 years of age or older: younger people may still have eyes that are growing. In certain cases, individuals younger than 21 may have LASIK surgery.
There is no upper age limit for LASIK.
- Dissatisfied with wearing glasses or contact lenses.
- Have had no change in glasses or contact lens prescription for at least a year.
- Have otherwise healthy eyes.
- Be willing to accept a small amount of risk associated with surgery.
- Understand that glasses and/or contacts are occasionally still needed for some activities after surgery.
- Not have excessively thin corneas or extremely high levels of refractive error. Your doctor will test for these conditions on your evaluation exam.
These conditions may prevent you from undergoing Blade-free LASIK. You should alert your eye surgeon if you have one or more of these conditions so that he or she can help you make the best choice about undergoing refractive surgery.