Blade
Vs. Bladeless in LASIK Surgery
Many
people that feared going “under the knife” for certain
types of LASIK eye surgery may be surprised to find that the new
bladeless technology provides dubious results. The Mayo Clinic
recently conducted a comparison study on the use of femtosecond
lasers (those used in the new bladeless LASIK surgeries) versus
the use of the traditional mechanical microkeratome used in regular
LASIK surgeries. Their findings were surprising in that the use
of a femtosecond laser did not yield significantly better results
in LASIK patients. In fact, patients who underwent the regular
microkeratome based LASIK surgery had results that were virtually
indiscernible from those of the bladeless patients after the six-month
recovery period.
These findings are especially significant in light of recent claims
that the bladeless laser procedure provides not only better results
but also yields fewer complications or side effects than the microkeratome-based
operation. Because of the importance of these results and their
possible impact on public opinion, they are to be presented to
the ARVO (or Association for Research in Vision and Ophthalmology)
for future action.
With this revelation in mind, potential LASIK surgery patients
now have a choice to make: the tried and true mechanical microkeratome
surgery, or the bladeless new femtosecond surgery? Both procedures
can treat a variety of patients with conditions ranging from nearsightedness
to farsightedness to astigmatism. In each surgery and for each
affliction, the surgeon reshapes the corneal surface.
With traditional surgeries that use the mechanical microkeratome,
a trained surgeon cuts a flap in the cornea to reshape its surface.
With femtosecond-based surgeries, the surgeon cuts the flap using
a new laser. Because it removes the hands-on aspect of the surgery,
this operation is also alternately called the “all laser”
surgery.
Initially, it was reported that the new bladeless surgery was
more efficient and yielded better results. The results of the
Mayo Clinic’s study effectively refute this by showing that,
at the end of the recovery period, there are negligible differences
in the vision improvement, side effects, or overall success rates
of patients of both types of surgeries.
Nevertheless, many eye surgeons that perform LASIK procedure still
prefer the bladeless surgery. They contest that it is safer because
of its ability to reduce the margin of error inherent in mechanical
microkeratome surgery. Though the results of the study do not
reflect these beliefs, proponents of the bladeless surgery insist
that it is the better method. They insist that the laser’s
controlled precision reduces the risk of over or under correcting
and cite the laser’s ability to map the cornea as advantages
over microkeratome.
On the other hand, even prior to this study the standby microkeratome
surgery reported a relatively low risk level. Some rare but serious
negative results included total vision loss or dramatic impairment
following the surgery, but these conditions occurred in less than
one percent of all patients that completed the procedure.
Results of the study imply that the surgeries are both relatively
safe but share similar risks. The results reported were based
on the long-term recovery of LASIK patients. In other words, odds
are at the end of either procedure you will have the same results,
for better or worse. Bladeless femtosecond surgery does have the
benefit of speed; because of the automated precision of the laser,
the procedure typically takes less time. Also, many people shiver
at the concept of someone literally cutting their eye, while other
people are uncomfortable with the idea of a laser looming over
them. Ultimately, if you believe that both methods are truly equal,
then the decision of which to undergo comes down to comfort and
personal preference.
