How does the cut for the corneal flap differ when comparing between blade and bladeless LASIK, and what impact does this have on the risk of dislodgement of the flap?

Doctor's Answers (1)

The term blade / bladeless LASIK refers to the method of cornea flap creation. Bladed Lasik utilises a mechanical keratom or blade, whilst bladeless LASIK refers to a femto-second laser which is utilised to create a cornea flap.

In general, studies comparing the 2 forms of flap creation, have indicated that for bladeless-Lasik, the flap depth is more predictable and accurate (closer to the intended depth), less likely to have flap-related complications including incomplete flap, button-hole flap etc. Flaps are also less likely to move or dislodge following surgery.

Bladed Lasik does have the advantage of a smoother flap interface, hence the immediate post-operative period is noticeably clearer with less concerns of "cloudiness" immediately after surgery.

The long-term outcomes are similar with both forms of flap-creation.


References:

1. Kanellopoulos AJ. Topography-Guided LASIK Versus Small Incision Lenticule Extraction (SMILE) for Myopia and Myopic Astigmatism: A Randomized, Prospective, Contralateral Eye Study. Journal of Refractive Surgery. 2017;33(5):306-312. doi:10.3928/1081597x-20170221-01 ‌

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