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All Laser LASIK Eye Surgery Safer – Both Blade and Laser Equally Effective In Treating Nearsighted Farsighted and Astigmatism

May 6th 2006

All Laser LASIK Eye Surgery Safer – Both Blade and Laser Equally Effective In Treating Nearsighted Farsighted and Astigmatism

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The Mayo Clinic reports that femtosecond (bladeless) and mechanical microkeratome LASIK surgeries produce equal results, using a variety of eye health measurements.  LASIK (Laser-assisted in situ keratomileusis) involves treating nearsightedness, farsightedness or astigmatism by reshaping the eye's cornea to alter the way the eye refracts light.  The older traditional method involves using a blade to create a flap, and then removing a defined amount of corneal tissue by an excimer laser.  Doctors then replace the flap.

The newer technology uses a femtosecond laser to create the flap.  Evidence now shows that this news procedure is just as affective.  Dr. Sanjay Patel said “At six months after surgery, there are no differences between the eyes that had bladeless or microkeratome LASIK with respect to visual acuity (vision as measured by reading an eye chart), contrast sensitivity (ability to discriminate bright objects from dark objects), or in perception of stray light or glare, such as the glare from oncoming headlights."  Sanjay is a Mayo Clinic ophthalmologist and study investigator.


The all LASIK procedure, sometimes referred to as bladeless LASIK, may also be safer.  Sanjay says “I'd say the short-term outcomes are equal and the risks are, in theory, less with the bladeless technique, although our study was not designed to compare risks. Bladeless LASIK is potentially safer because of its computer-controlled precision, the ability to visualize the flap being created, and to stop the procedure whenever necessary. That said, however, the risk of complications with a traditional, microkeratome blade is very small: some vision loss from surgery with a microkeratome blade occurs in well under 1 percent of all cases. The long-term risks of either procedure, however, are unknown, and defining them is the primary purpose of our study."

Although safety was not measured, after comparing all of the variables, Dr. Patel prefers the bladeless LASIK because of its safety.  The researchers followed 20 patients who received LASIK for nearsightedness or astigmatism.  Each participant was treated with microkeratome LASIK in one eye and bladeless LASIK in the other eye.


There was no difference in subbasal nerve density between types of surgery, though the density decreased after both treatments compared to density before LASIK.  Neither subbasal nerve density nor corneal sensitivity impact vision, but they do affect the way the eye can heal from a scratch or other injury.

During the first three months the eye treated with bladeless LASIK had a higher degree of corneal backscatter than the traditional procedure.  Patients could not perceive the difference after three months. High-contrast visual acuity, the capability to see fine details, and contrast sensitivity, the ability to perceive contrast in objects and their environments, also did not differ between LASIK types.

Backscatter is haziness in the cornea that is usually invisible to the naked eye and is identified through testing in a physician's office. Cell densities in all layers of the cornea also did not differ between the LASIK surgeries.  The Mayo Clinic researchers hope to obtain long-term information about patients' vision and eye health five years following surgery.  The current research will be presented next week in three abstracts at the Association for Research in Vision and Ophthalmology meeting in Fort Lauderdale, Fla.

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Dan Wilson
Best Syndication

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