Femtosecond or Bladeless LASIK
Femtosecond laser has revolutionized laser refractive surgery. It is a precise, cutting tool that can make corneal surgery accurate and safe. Two lasers are used in this procedure. It entails making a corneal flap with a femtosecond laser as a first step followed by excimer laser power correction below the flap as the next step.
STEP BY STEP PROCEDURE
Flap created using highly precise Femtosecond laser.
Flap folded back exposing inner corneal tissue
Excimer laser reshapes cornea & corrects refractive error
Flap folded back to original position
Femto versus Blade Flap
- Predictability of flap thickness is better with femto-flaps i.e., a 100 micron femto-flap will be 100 micron whereas there can be variations with a microkeratome flap
- Predictability of flap diameter is better with femto made flaps
- Corneal size and curvature plays an important role in success of blade flaps while femto- flaps are independent of these variables. A steep or flat cornea can pose difficulty in flap creation with microkeratome/blade.
- Femtosecond flap making is a safer procedure with fewer complications (buttonhole, incomplete flap) as compared to blade lasik.
- Femtosecond laser makes a vertical cut at the edge of the flap as apposed to the sloping edge of the blade flap.
- This results in better flap alignment and healing.
- Complications of epithelial cells growing under the flap edge are lesser in a femto-flap.
- Chances of flap displacement are lesser as the flap sits better.
- Femto laser makes planar, uniform flaps.
- Takes 20 minutes for both eyes together
- Numbing drops/ topical anesthesia used- no injection, no patch, no pain, no stitches, no blood
- One has to lie down for the duration of the procedure
- Eye is kept open and cannot be closed by the patient
- Two different laser machines are used
- Femto laser makes a flap in right followed by left eye
- Patient bed then moves to the next laser
- Excimer laser corrects power in the left and then right eye.
- Doctor’s instructions are to be followed during the procedure
- There is no pain or discomfort during the process
- Goggles are given
After the procedure:
- Expect to see blurry and experience some watering, irritation on the day of treatment
- The day after, vision and comfort will be better
- Care to be taken while instilling drops to not disturb the flap
- No water in the eyes and head bath for 7-8 days
- Protective sunglasses outdoors for two weeks
- Side-effects: Dryness, glare, light sensitivity, night vision blurry These are common and gradually get better over a few weeks.