Demystifying the Role of Lasers in LASIK

When most people think of lasers, the images that come to mind are of lightsabers and anti-theft systems meant to thwart burglars in the movies. As cool as they are, lasers also have everyday, but very important, roles. They assist with law enforcement, commerce, and of course with medical procedures.

In the popular imagination, eye surgeries automatically involve lasers. While this is not entirely true, the role of lasers in ophthalmological surgeries is steadily growing larger. One of the most well-known eye surgeries – LASIK eye surgery – involves lasers. In fact, it’s right there in the name!

But what exactly are these lasers that are used in LASIK eye surgery?

I’d Like You To Meet My Assistant, Excimer
Eye surgeries like LASIK, which stands for Laser-Assisted In-Situ Keratomileusis, use what is known as an excimer laser. LASIK is a corrective surgery that corrects refractive errors. Your cornea, the transparent, top most layer of the eye, helps focus light and produce an image that your brain can process. Imperfectly shaped corneas lead to vision problems. It is the excimer laser that allows your doctor to reshape the cornea and correct refractive errors.

The excimer laser is an ultraviolet laser. Initially, the role of lasers in LASIK eye surgery was primarily to reshape the corneas. A microscopic blade known as a microkeratome is used to cut a flap in the cornea that then allows the doctor to use the excimer laser to reform the eye. But in the last decade or so, a new rather attractive method of LASIK has risen in popularity: bladeless LASIK.

Doctors Can Go Bladeless with a Femtosecond Laser
Generally speaking, a LASIK eye procedure goes as follows: the patient is provided numbing drops, the doctor makes an incision using a microkeratome, they use an excimer laser to reshape the eye, and then they seal the corneas back up to allow them to heal.

For many people who are considering LASIK eye surgery, the thought of sharp blades going anywhere near their eyes is a horrifying image. Since 1999, an alternative option has been available, bladeless LASIK eye surgery, and this is carried out using a femtosecond laser. The most popularly known bladeless LASIK method approved by the FDA is known by and has been marketed as iLASIK.

While LASIK eye surgery procedures that use femtosecond lasers can technically be considered “bladeless” it is important to keep in mind that both involve penetrating the cornea. Some believe that a more accurate term is “all laser” LASIK eye surgery, although saying bladeless LASIK is not a lie since there is no blade involved.

At the moment, bladeless LASIK is not necessarily considered better than LASIK surgery using a microkeratome. In fact, there are eye surgeons who say that the procedures goes smoother for them when they use the blade while others use them depending on their consultation with their patient.

That last bit is the most important: it is about what is best suited for the patient. In all situations, whether it’s LASIK or a routine eye exam, we here at UCLA are firmly committed to doing what is best for each of our patients. Considering LASIK? Think you need a vision test? In need of a comprehensive eye exam? Contact the Santa Monica Eye Medical Group today!

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