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Bladeless LASIK: How Does Bladeless LASIK Surgery Work?

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Bladeless LASIK, sometimes referred to as all-laser LASIK, uses a laser to create the corneal flap. In traditional LASIK, a blade is used. 

Bladeless LASIK may offer more precision than traditional LASIK.

What Is Bladeless LASIK?

Bladeless LASIK uses all-laser technology to treat refractive errors. It differs from traditional LASIK because of the tools used to create the flap. 

Instead of using a specialized blade (microkeratome), the surgeon deploys a femtosecond laser, an advanced and high-energy laser. It increases the precision of the procedure. 

How Does Bladeless LASIK Surgery Work?

With LASIK surgery, the cornea is reshaped using a laser, so it can correctly process and “bend” light to send to the retina. In order to reshape the cornea, a small flap is created to allow for access to the tissue that needs to be reshaped. With bladeless LASIK surgery, that flap is made with a laser.

After reshaping, the flap is placed back over the cornea. The flap naturally adheres to the eye tissue, so there’s no need for any sort of stitching or attachment.

What to Expect

The bladeless procedure starts with a screening examination to determine if you are the right candidate for the surgery. You will also have a second evaluation after the first one determines that you are a good candidate. 

The second consultation is a preoperative evaluation and is more comprehensive. Two weeks before the procedure, your doctor will ask you to stop wearing your contact lenses.

The procedure takes less than 30 minutes. A numbing drop is placed in your eye, and the doctor cleans the area around your eye. Your other eye is covered during the procedure while the other eye’s lids are held open with a lid speculum.

The Pros & Cons of Bladeless LASIK

Bladeless LASIK uses only lasers throughout the whole procedure. Traditional LASIK does not.

Advantages of Bladeless LASIK

  • Because there is no blade used to cut a flap, there is a lesser risk of complications or tissue damage. Laser treatment increases precision which significantly reduces the risks of complications.
  • Bladeless LASIK results in better flap quality because it achieves the same flap thickness despite the initial shape of the patient’s cornea. With traditional LASIK, there is a risk of buttonholes showing up in the cornea since it is not as precise.
  • Bladeless LASIK results in less severity of the dry eye side effect, and it also lasts for a shorter duration than with traditional LASIK.

Disadvantages of Bladeless LASIK

  • There’s a higher risk of light sensitivity after surgery, but only as a temporary side effect.
  • There may be a higher risk of a condition called diffuse lamellar keratitis (DLK), which causes inflammation under the flap of the cornea. The condition is uncommon after LASIK and usually treated with medication.
  • Some doctors may charge more for bladeless LASIK.

The Pros & Cons of Traditional or Microkeratome (Bladed) LASIK

In a traditional LASIK procedure, a device called a microkeratome uses high-precision oscillating blades that are attached to a small suction ring to create a flap in the corneal tissue, which will allow the laser to reach the lens. 

Advantages of Traditional LASIK 

  • Flap creation takes about 30 seconds total compared to between 30 and 45 seconds for the femtosecond laser.
  • In all-laser surgery, you may be moved between rooms due to the different laser systems that are needed. In traditional LASIK, you will remain in the same room the whole time.
  • Microkeratome devices can cut through abnormalities in color or opacity in the cornea or pupil without trouble, while lasers must be recalibrated.

Disadvantages of Traditional LASIK

  • Traditional LASIK offers less precision than bladeless LASIK.
  • Many modern practices and doctors are opting for bladeless LASIK.
  • There’s a higher risk of dry eye side effects.

Both Approaches to LASIK Work Well for Most People

Both traditional LASIK and bladeless LASIK are effective methods for treating refractive errors in most people. While each has its pros and cons, there are no significant differences in the outcomes or risk of complications.

One study from 2017 found no statistical differences in terms of efficacy, aberrometric changes and safety. However, the study found that bladeless LASIK offered a greater advantage in predictability and achieved higher accuracy on flap thickness.

Cost Comparison

Bladeless LASIK may be slightly more expensive than traditional LASIK. The difference between the average prices for the two procedures ranges from $200 to $400 but could be higher in some cases. Your location and prescription also influence the final cost of the procedures.


  1. What Is LASIK? (July 2018). The U.S. Food and Drug Administration.
  2. LASIK – Laser Eye Surgery. (December 2015). American Academy of Ophthalmology.
  3. Creating LASIK Flaps: Femtosecond Laser vs. Mechanical Microkeratome. (July 2007). American Academy of Ophthalmology.
  4. Comparison of the Femtosecond Laser and Mechanical Microkeratome for Flap Cutting in LASIK. (August 2015). International Journal of Ophthalmology.
  5. The Basics of LASIK Eye Surgery. (August 2012). Federal Trade Commission Consumer Information.
  6. Visumax Femtolasik Versus Moria M2 Microkeratome in Mild to Moderate Myopia: Efficacy, Safety, Predictability, Aberrometric Changes and Flap Thickness Predictability. (July 2017). BMC Ophthalmology.
  7. What Should I Expect Before, During, and After Surgery? (November 2018). U.S. Food and Drug Administration.
  8. Laser Surgery Can Improve Vision Problems. (2021). University of Rochester Medical Center.
  9. Diagnosis, Clinical Trend, and Treatment of Diffuse Lamellar Keratitis after Femtosecond Laser-Assisted in situ Keratomileusis: A Case Report. (2018). Case Reports in Ophthalmology.
  10. Cornea. Cleveland Clinic.
  11. Anatomy of the Eye. University of Michigan Health.

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