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Question:
A local ophthalmologist is advertising LASIK by creating the corneal flap with a laser. Is this method more beneficial (clinically or otherwise) than the traditional flap procedure?

Answer:
This technique is marketed as all-laser LASIK or Blade-free LASIK since it avoids the use of the metal blades known as microkeratomes that traditionally were used to create the LASIK flap. The laser is known as a femtosecond laser and it allows more precise flap creation with more reproducible flap thickness compared to microkeratomes in peer-reviewed published reports. Some publications suggest femtosecond or all-laser LASIK creates less risk of dry eyes, epithelial in-growth (a complication of LASIK in which surface cells migrate under the flap and distort vision), and less risk of traumatic flap dislocation. The only proven advantages thus far are less risk of abnormal flaps known as buttonholes or free flaps. These did not occur often with microkeratomes, but when they did occur, they oftentimes caused a decrease in correctable vision. Femtosecond lasers have been shown to reduce (not eliminate) this risk of an irregular flap. Despite these advantages, the technology is more expensive than traditional LASIK with a microkeratome.

Answered by: W. Barry Lee, MDDr. W. Barry Lee

Categories: Eye Surgery, Vision Correction

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Answered: Nov 17, 2014

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