How Femto Lasik Is Safer For Your Eyes

It is no secret that lasik has a flap. Well, no secret to anyone that has learned a little bit about lasik. That flap is what makes lasik work so quickly! For many, the thought of having a flap can be concerning. Even worse some people talk about using a blade to slice and create the flap! Is this really how lasik is done?

Fortunately, modern femto lasik doesn’t use a blade! But historically, blades were used for lasik. The blade itself is called a microkeratome and this microkeratome was used to create the lasik flap on the cornea. Now, lasik using a microkeratome was generally safe. The blade had a set path it could travel and thus could create a straight and regular lasik flap. However, the microkeratome wasn’t perfect and it was possible to get flap-related complications. Thus, lasik progressed beyond the blade into the age of lasers.

Lasik with Blades VS Lasers

Modern lasik is performed entirely by lasers. The femtosecond laser took over the role of the microkeratome and can create perfect and precise lasik flaps (femto lasik is short for femtosecond lasik). We no longer have to rely on a blade to make microscopic cuts in the cornea. Because of this, lasers offers a huge benefit over microkeratomes with improved safety and accuracy!

At first, lasers could still only create flat lasik flaps similar to how the microkeratomes worked. But over time technology progressed allowing the lasers to create pretty intricate patterns. The laser is capable of changing direction and creating more complex structures than what the blade is capable of. This led to the creation of 3D lasik flaps. While the lasik flap is still mostly flat, the sides of the lasik flap are created to allow the flap to lock in place like a manhole cover. This feature adds strength and security.

_{Lasers create 3D lasik flaps; Image by Unknown author / Public domain}

The downside is that mores lasers add a little to the cost of the procedure. Because of this, you still will find some surgeons that try to provide a very cheap price by using a blade or microkeratome for lasik. So what is the main difference between a blade and a laser for lasik?

Safety

Many of the improvements lasers have over blades deal with safety. Lasers create predictable flaps at consistent depths in the cornea. Blades on the other hand generally work well, but there are rare events where the blade doesn’t cut the cornea properly. And when the blade doesn’t cut well, either lasik is no longer an option or in the worst case you can lose vision from the irregular cut.

Because of some of the irregularity blades can have when making lasik flaps, blades cut deeper into the cornea to minimize the chance this irregularity causes serious issues. Making deeper cuts into the cornea has two outcomes.

• The first is that it causes more dryness since more of the cornea is affected.
• Secondly, it can limit the total amount of prescription that can be safely treated since from the start more cornea is affected by the lasik flap.

Strength

The other main difference between lasik flaps made with blades and those made with lasers concerns the long-term stability of the flap. In the past, the lasik flap was considered a point of weakness. Lasers have changed that narrative. Lasik flaps created with laser strengthen over time compared to those made with blades.

The microkeratome blade made it really easy to slice a very smooth flap in the cornea. Having a perfectly smooth lasik flap, however, doesn’t provide a lot of friction to prevent the flap from being dislodged. The flap just doesn’t hang on to the eye as much as it should.

Laser created lasik flaps, on the other hand are created very differently. Very precise and overlapping pockets are created right next to each other. The surface appears smooth but in reality the surface has some microscopic roughness. In addition, the side of the lasik flap can be sloped causing the lasik flap to fit like a puzzle piece. Just these two factors alone make the lasik flap a whole lot more secure. However, on top of this, the very edges of the lasik flap develop a slight amount of scarring in order to fully secure the lasik flap on the surface of the eye.

_{*Lasik flap locks in place like a puzzle piece; Image by Alexandra, Alexas_Fotos / CC0}

Do I Need To Be Concerned About The Lasik Flap?

The lasik flap is the source for one of the largest concerns about lasik. After lasik, the cornea isn’t exactly the same as it was before lasik. On the plus side, your vision now works, however, the cornea, instead of being completely solid, now has a lasik flap in place. The concern is that being hit in the eye or even simply rubbing the eye can cause the flap to move. Fortunately, this need not be a concern after lasik.

It is very uncommon nowadays to have issues with lasik flaps. I know, because, when we lift up lasik flaps to do enhancements, the flaps are well secured. Nothing in life is impossible and if you do expect to get regular trauma to the eye, such as would happen with a boxer or MMA fighter, than PRK may be a better option. But otherwise, you really need not be concerned with the lasik flap and can just live your life!

Summary

Femtosecond laser lasik flaps have revolutionized the field of lasik. So much so that it really doesn’t make sense to settle with inferior techniques of correcting your vision.

You can still find some places that use a blade with lasik. But given all the improvements that lasers have swept in, it is a no-brainer nowadays to get lasik done with all lasers!

See also Finally Make Sense of All The Different Types Of Lasik on EyeMountain.com to learn more

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