What Is the Difference Between Blade and Bladeless LASIK?

Here at the California Center for Refractive Surgery, we take offering the best in eye care seriously. We aim not just for quality care but also education. That’s why we want to talk about blade vs bladeless LASIK.

The medical community uses LASIK surgery to correct a range of refractive errors. Laser-assisted in situ keratomileusis (aka, LASIK) has become the most advanced and common vision correction procedure outside of eyeglasses.

In that regard, let’s take a look at the two types of LASIK and see what the difference is between blade and bladeless LASIK.

LASIK Simplified

LASIK is a painless procedure promising a fast recovery with little to no post-discomfort. In the procedure, the ophthalmologist administers an anesthetic eye drop. Some cases may require a relaxant.

After completing the preparation, the surgeon will use a microkeratome or femtosecond laser to create a flap in the cornea. They’ll pull the flap back. Then, they’ll deploy another laser, an excimer, to remove corneal tissue. This is a specialized UV light that removes microscopic tissue amounts. It allows for precision reshaping of the cornea.

During a LASIK procedure, the physician will use a suction ring set at the front of the eye. This is to prevent the eye’s movement or contact loss that will impact flap quality. This is a critical component of LASIK surgery.

The procedure is always customized. For instance, if correcting nearsightedness, we flatten the cornea. If working with farsightedness, we adjust the cornea to be steeper. For astigmatism, a more normal shape gets applied to the cornea by smoothing any abnormal elements in the eye.

With the operation completed, the flap gets put back in place. With LASIK, no bandages or stitches are necessary. The cornea will heal naturally. The patient may experience temporary burning or itching. After a post-op exam, the patient goes home.

Blade or Bladeless LASIK Surgery?

Whenever the surgery employs a microkeratome, this is a LASIK blade surgery. The instrument has an oscillating blade that allows a cut to create a hinged, thin flap in the cornea. It sounds painful, but it isn’t. With proper preparation and under the hands of a professional, the patient doesn’t feel a thing.

A blade-free LASIK surgery procedure uses a femtosecond laser. Instead of a blade, the femtosecond utilizes a high-energy laser to create corneal flaps.

Outside of that, there is no difference between LASIK applications. When it comes to blade vs bladeless LASIK, which tool is best is a measure of a patient’s unique conditions. How to deal with these conditions is a discussion for the patient and ophthalmologist.

Blade / Microkeratome Conditions

Here’s what you should know about blade-based corrective eye surgery:

• Preferred procedure for correcting previous LASIK surgeries
• May be more comfortable
• Requires less suction
• Preferred surgical procedure for patients suffering glaucoma
• Risk of complications minimized
• A shorter operation compared to bladeless

Bladeless / Femtosecond Conditions

Here are a few points to take into consideration about bladeless LASIK surgery:

• Noticeably lowered risk of flap complication or thickness variation
• Post-surgery vision typically better compared to blade procedure
• Touch-up surgery rarely required with most patients
• Safe treatment for patients with thin corneas or serious refractive errors
• Reduction of postoperative complications
• Extremely gentle to the human cornea

Please remember that one procedure isn’t better than the other. An ophthalmologist needs to examine a patient to determine the best approach to correcting vision issues.

Blade LASIK vs. Bladeless

Outside of the tool used, there’s no considerable difference between the two types of eye surgery.

It’s said the bladeless procedure offers a better quality of vision. Research seems to confirm this. One day after a procedure, researchers found that 68% of bladeless patients had acquired 20/16 vision. A follow-up study found this was consistent through first-week post-op and one-month post-op.

The medical community appreciates the blade procedure for its comfort and speed. Microkeratomes are a quick application. This results in a better patient experience. The blade-based LASIK is ideal for the patient in need of minor vision corrections.

The blade procedure requires less suction. Typically, surgeons only need about three seconds to apply the application for suction, compared to bladeless LASIK surgery that could need anywhere between 15 and 20 seconds for suction.

The greatest benefit of the bladeless performance is control. Bladeless laser eye surgery, compared to blade procedures, significantly reduces the risk of flap complications such as buttonholes (abnormal lamellar cuts), partial flaps or free caps (where the hinge of the corneal flap detaches). 

The bladeless process is better suited for patients who need exacting precision because of unusual refractive issues or particularly sensitive eyes.

Bladeless LASIK surgery may use IntraLase. It’s not unusual to find a patient whose thin corneas make LASIK treatment risky. The surgery might use IntraLase for these patients because it enhances precision. IntraLase gives those risk-potential patients the opportunity to improve their vision through surgery.

With IntraLase, the surgeon can achieve a uniform flap thickness. The curve of the cornea impacts the flap. In blade LASIK, the cornea can affect the flap centrally. That dramatically increases the possibility of a buttonhole or other unwanted cut. IntraLase reduces this possibility.

Ultimately, which procedure to apply depends on varying factors to discuss with the clinician regarding general and visual health. On top of that, if a patient’s working with a reputed surgeon, both blade LASIK and bladeless are safe and lasting solutions for common vision problems.

Top Things to Look for in an Eye Surgeon

Finding the right ophthalmologist is the only way to ensure, regardless of blade vs bladeless LASIK surgery, the operation goes smoothly. Here are the top things to look for:

• The clinician should be board-certified in ophthalmology and specialize in LASIK surgery.
• The clinician should have experience treating patients with the specific type of vision problem the patient has.
• The patient has to be comfortable talking with a surgeon ready to fully answer questions.
• The clinician should discuss blade and bladeless procedures and why they prefer one over the other for a patient.
• Note how open the ophthalmologist is. If they’re sketchy or they induce discomfort, this may be the wrong doctor to consider. A good clinician respects a patient’s concerns and opinions and freely answers questions.
• Look for a surgeon who accepts your vision insurance or has a reasonable payment plan. There are vision plans that offer a discount on LASIK.

A consultation with an eye care professional is really the only way to get an understanding of which procedure is best for you. At the California Center for Refractive Surgery, we’re dedicated to providing personalized eye care and vision correction using the latest technology and advanced procedures for safe, reliable and affordable results.

LASIK may be a common procedure today, but it’s important to take each aspect of the process seriously. There are suitable surgeries for thin corneas, high correction, dry eyes and more. We look for risks such as halo and glare, increased regression, aging and other factors. Every patient receives a customized plan unique to their condition.

At the California Center for Refractive Surgery, we’re committed to guiding every patient through each step, the end result being the best vision technology offers. Are you interested in getting laser eye surgery? If so, contact us today, and we’ll guide you through the process.