“Laser-assisted in situ keratomileusis”, or LASIK, is the refractive eye surgery most commonly performed in Arizona. LASIK's popularity is due to a combination of its effectiveness and its convenience. There is very little pain or down time, and patients often notice results just a few hours post-surgery. LASIK works to correct nearsightedness, farsightedness, as well as astigmatism. Some newer, more advanced LASIK techniques do not even use a blade, and eye doctors can perform the surgery in less than five minutes.
Bladeless LASIK, also known as “all-laser” LASIK, replaces the standard non-laser tools used in LASIK with an infrared laser. The flap in the cornea which is typically created using a microkeratome blade is instead created by a specific pattern of minute, overlapping spaces made by the infrared laser just below the cornea's surface.
Bladeless LASIK uses two types of lasers. The femtosecond laser creates a hinged flap in the cornea, which is lifted so that the eye surface beneath can be accessed. This laser operates at exceptionally high speeds and actually divides the tissue on a molecular level in a manner that does not transfer heat or damage to surrounding tissues. The first femtosecond laser to receive FDA approval for LASIK use in the U.S. was the IntraLase laser. It was approved in 2001.
Six years later, Abbott Medical Optics (then Advanced Medical Optics) acquired IntraLase and incorporated it into its proprietary CustomVue excimer laser technology. Abbott Medical Optics refers to the new system as iLASIK.
The second laser used in Bladeless LASIK is the excimer laser, the tool which performs the actually surgery on the exposed eye surface. This laser removes tissue in a specific pattern in order to permanently alter the shape of the cornea. Once the re-shaping is complete, the flap, whether generated by blade or laser, is replaced on the eye, acting as a natural bandage. The reshaped cornea should allow patients to experience sharper vision almost immediately.
Bladeless LASIK is believed to result in fewer surgical complications. Femtosecond lasers create flaps that are less likely to tear than their traditional blade-generated counterparts.
Patients also enjoy the fact that certain complications can be avoided with IntraLase LASIK, such as “buttonholed” or partly-formed flaps that can result during eye surgery conducted using a handheld microkeratome blade.
IntraLase is also associated with fewer post-surgical eye infections because there is less chance of contamination by tear film or debris being “dragged” under the flap.
Recovery after IntraLase is comparable to recovery after traditional LASIK. Typically, patients report mild eye irritation or discomfort for one or two days following either type of surgery.
Other benefits of bladeless LASIK include fewer incidences of dry eye and fewer follow-up “touch-up” procedures required. This makes bladeless LASIK a desirable alternative to traditional LASIK for many potential patients who are carefully considering their refractive surgery options to achieve the best possible outcome.
PRK Surface Ablation
PRK is a refractive eye surgery that was developed in the 1980s and was a precursor to traditional LASIK.
Both PRK and LASIK correct nearsightedness, farsightedness and astigmatism. The difference between PRK and LASIK is that during LASIK, doctors create a corneal flap using a blade while with PRK they gently remove a layer of cells on the cornea’s surface, a process called surface ablation.
Both procedures use an excimer laser to permanently re-shape the cornea.
Vision Correction Surgery with ICL
Another surgical alternative to LASIK are surgically implanted intraocular lenses, or phakic IOLs.
These implantable refractive lenses may be able to produce even better vision than LASIK, especially for those with severe myopia. They are placed either between the cornea and the iris or just behind the iris. Phakic IOLs are similar to the IOLs used in cataract surgery, however, the natural lens is not removed when phakic IOLs are implanted.
Currently, two IOLs are FDA-approved for use, the Verisyse and the Visian ICL. They are approved for treatment of nearsightedness only; however clinical trials are underway for IOL correction of farsightedness and astigmatism.
The minimally invasive procedure takes only 15 minutes, gives immediate results, and needs only a 1-2 day recovery. Visian ICLs also protect the eye from Ultraviolet rays, and can be removed if necessary.
Risks & Benefits