I find the idea of someone cutting a part of my eye to fix my sight rather unnerving, especially as I’d be wide awake whilst it’s being done! Is there a possibility that I could undergo laser eye surgery without being subjected to any ‘blades’?

 
 

Yes, ‘bladeless’ laser eye surgery is available. Most laser eye surgery procedures require the precise cutting of a thin flap in the cornea (usually of a width less than 100 microns i.e. less than the width of a normal human hair). This corneal flap is then folded over to reveal the corneal tissue beneath that will be reshaped by laser to correct a visual impairment.

Traditionally, the incision and creation of the corneal flap has been made with a hand-held surgical instrument called a Microkeratome which features an incredibly fine oscillating steel blade. A newer technique for creating the corneal flap, IntraLase, is entirely bladeless and uses a Femtosecond laser (different from the Excimer laser used to actually reshape the cornea).

Opinions vary as to which method—Microkeratome blade or Femtosecond laser—is better, since both technologies have advanced significantly in terms of safety, precision and the reduced possibility of complications. It should, however, be noted that whilst use of a Microkeratome is the faster technique for creating a corneal flap (at around 3 seconds as opposed to the Femtosecond laser’s 15 to 20 seconds), a marginally wider range of corneal types can be treated with the Femtosecond laser. Additionally, those who prefer the option of an entirely bladeless laser eye surgery can expect to pay significantly more per eye for the Microkeratome option.

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