When one comes across the term “bladeless” in LASIK, one expects it to be not involving the use of a ‘blade’. In other words, the expectation is also that there is no ‘cut’. This is misleading. It is definitely a method where the automated instrument called the ‘microkeratome’ used in Wavefront LASIK is not used.
However, not many are aware that there are different types of Bladeless LASIK. All LASIK centres in India or Mumbai may not offer these treatments to you, as they may not have the 3 different technologies required for it.
3 kinds of All-Laser LASIK or laser treatments that we perform at Shroff Eye Hospital, Mumbai:
- Bladeless Femtolaser or Femtosecond Wavefront LASIK
- Bladeless Eye SMILE- ReLex – FleX laser treatment
- Bladeless Wavefront EpiLASIK or Surface Ablations
Which of these treatments is best for your eyes and your lifestyle is determined during a thorough LASIK evaluation examination with Dr Anand Shroff, our LASIK surgeon.
Read on for further information on these treatments and the reasons we recommend them for.
1. Bladeless Femtolaser Wavefront LASIK – Many use synonym terms such as i-LASIK, intralase etc. for this procedure. This laser treatment involves the making of a corneal flap, but by using a Femtosecond laser instead of a microkeratome. Hence, termed ‘bladeless’. After this step, a second laser is ALWAYS needed (the excimer laser) to treat the powers. Here we use the Zeiss VisuMax laser to create the flap and the Concerto 500 Hz laser to treat the powers.
Many people assume that using a good Femtosecond laser gives a successful treatment; many end up focusing on only the ‘bladeless’ part of the procedure disregarding or ignoring the other more important steps of the LASIK/ laser treatment.
The Femtosecond laser was introduced with the sole purpose of reducing flap-related complications and creating more precise flaps. That is all! It is Not a replacement for lasers which actually treat the powers. This laser does not treat powers, and only helps in the first step involving creation of the ‘corneal flap’. But, the second laser which is applied is more important as this laser is the one that reshapes the cornea and treats the powers…the reason for your visit to the eye surgeon! We use the 500 Hz Concerto system, the only one in India and in few centres in the world. Many centres may market their LASIK treatments as ‘Bladeless LASIK’ but do not invest in a good excimer laser, the one which actually treats your power. So, if considering bladeless LASIK, please make sure that both lasers used are advanced laser systems. The advantage over the microkeratome is when one needs a precise laser –made corneal flap.
2. Bladeless ReLeX or Eye SMILE or SMILE or FLEX procedures – Many are not aware of this technology as it is relatively new and not many centres have them considering cost of infrastructure involved in it. In FLeX procedures the corneal flap is created with the Femtosecond laser and the very same laser also creates a ‘lenticule’- the part that needs to be removed to achieve 20/20 vision. This simply means that instead of a complete laser ablation to remove the power from the cornea, gentler and lesser laser energy is applied which reshapes the cornea. The entire procedure is done on a single laser- the Zeiss VisuMax.
During SMILE laser treatments, there is no corneal flap. Here instead of an incision on the cornea which involves more than 3/4th of the circumference, a very small 1 to 3 mm incision acts as port of entry and exit, similar to keyhole laser treatment.
Advantage of this procedure is for those fearing a ‘cut’ on their eye as it is flapless, or those having high powers as this treatment gives better stability in the long term.
3. Bladeless EpiLASIK or Bladeless Trans Epithelial Surface Ablations – are when there is no corneal flap made. But here the treatment is very superficial working on the absolute surface layer called ‘epithelium’, similar to the ‘skin’ of the eye. So, in this treatment one either uses an ‘Epikeratome’ or the excimer laser to prepare the surface and the same excimer laser treats the powers. We use the Moria Epikeratome and the Concerto 500 Hz excimer laser.
When is this laser treatment recommended? It is when you have dry eyes or thin corneas.
The best step forward is to schedule an appointment with us to know the best option for you