LASIK was one of the first laser-based eye surgeries to treat most refractive errors. IntraLase was developed by Johnson & Johnson as an improvement on the basic LASIK procedure, and it is now one of the more popular bladeless LASIK operations. (Learn More)

There are many similarities between traditional LASIK and IntraLase, but the differences create subtle benefits and disadvantages. Understanding these can help you decide which might work better for you. (Learn More)

Because there are so many similarities, the risks and side effects are similar. Both operations have a very low risk of causing severe harm to your vision. (Learn More) Most people achieve 20/40 vision or better with either option.

The decision between IntraLase and LASIK is personal. Work with your eye doctor to decide which procedure might be your best option. (Learn More)

IntraLase vs. LASIK: Understanding Improvements to Refractive Surgeries

Laser-assisted in situ keratomileusis (LASIK) was approved by the United States Food and Drug Administration (FDA) in 1999. Since this vision correction procedure was approved, about 10 million people have benefitted from this fast, simple, outpatient operation.

LASIK’s popularity peaked around 2000, when an average of 1.4 million people received LASIK to correct their refractive error. Now, about 700,000 people get LASIK every year.

The original LASIK procedure involves two steps. First, a device called a microkeratome, which is a very small blade, creates a tiny flap of tissue on your cornea. This flap is pulled back for the second step, in which an excimer laser removes some corneal tissue to reshape this part of your eye, allowing light to refract more clearly onto your retina. The flap is then returned to its original place.

Although many eye surgeons still use the microkeratome for traditional LASIK, medical research sought a more efficient, less invasive method. Johnson & Johnson developed a device called the IntraLase femtosecond laser, which is used in some forms of bladeless LASIK to create the flap, rather than a microkeratome. While both IntraLase and traditional LASIK procedures work well for many people, you may benefit from one more than the other.

Which Is Better: IntraLase or LASIK?

IntraLase is a modification to the original LASIK procedure, making it less invasive, so you have a faster healing time.

There are not many differences between IntraLase and traditional LASIK, but each procedure has some subtle variances in their pros and cons. Understanding these, and who benefits from the differences between them, can help you decide which outpatient refractive surgery you would rather discuss with your ophthalmologist.

  • LASIK: Traditional LASIK is immensely popular worldwide. Many eye surgeons are trained on both the microkeratome and excimer devices.

    The operation is short, taking about 15 minutes or less per eye. Most of that time is setup, including numbing the eyes with drops and placing a device on your eyelids to keep them open. While there are two devices involved, there is little downtime during the transition.

    You will need to get a ride home since you cannot drive after LASIK. And you will need to rest your eyes for the remainder of the day. Most people have recovered their vision the next day, and they can return to work in a day or two.

    You may develop some side effects, like halos around lights, night vision problems, and dry eyes, which can last for up to six months. Serious complications are incredibly rare.

    • Pros: Traditional LASIK is a widely practiced and well-understood outpatient surgery. Ophthalmologists with training in microkeratome and excimer laser devices are easy to find and competitively priced. The cost of LASIK is about $2,000 to $3,000 per eye, depending on the skill level of your surgeon, where you receive treatment, and the general cost of living in your area.

      Because bladed LASIK has been performed millions of times for about 20 years, the side effects and risks are well documented. Your surgeon will be able to talk to you about your individual risks based on the history of this operation.LASIK is also able to manage several refractive errors, like myopia (nearsightedness), astigmatism, and hyperopia (farsightedness not due to aging). Your vision insurance may cover part of the procedure too.

    • Cons: There are several disqualifying factors for traditional LASIK, including having:
      • Naturally thin corneas.
      • Received LASIK in the past, leading to thin corneas.
      • An unstable refractive error.

If you undergo traditional LASIK once, and your vision is undercorrected or overcorrected, you may have to undergo a different, more invasive eye surgery to manage the problem. This means your healing time will be longer, and you may not achieve visual clarity (20/40 or better) without the help of glasses or contact lenses. While this is unlikely, some people have reported that they did not get good visual acuity after traditional LASIK due to overcorrection or undercorrection.

  • IntraLase: The IntraLase procedure refers to an approach to bladeless LASIK using Johnson & Johnson’s specific IntraLase femtosecond laser in place of the microkeratome. Using lasers for the entire procedure is less invasive than using a blade. It allows for greater precision in creating the flap as well as removing internal corneal tissue.
    • Pros: The IntraLase device requires less time than the microkeratome to create a flap on your cornea. According to Johnson & Johnson, IntraLase takes about 15 seconds, using laser pulses to create small bubbles, which allows your eye surgeon to gently lift this piece.

      Once the flap is created, the excimer laser can sculpt your cornea in another handful of seconds. The entire procedure takes 10 minutes or less per eye.

    • Cons: The main downside to IntraLase, compared to traditional LASIK, is that there are fewer surgeons who are trained to use the IntraLase device. If you want this procedure, you may have to travel a little outside your normal radius. This also increases the likelihood that you’ll need to use an out-of-network provider if you have vision insurance.

      There is also a specific side effect of IntraLase that is not associated with other devices. Transient light sensitivity syndrome (TLSS) is a rare side effect, occurring in 1 percent or less of IntraLase procedures. Reports of this condition began in 2004, and Johnson & Johnson say they have adjusted the IntraLase device to reduce this intense sensitivity to light, but there is still a small risk that you could develop TLSS after undergoing IntraLase.

Side Effects & Risks of IntraLase vs. LASIK

The risks associated with traditional LASIK and IntraLase are very similar since both procedures have similar steps and devices involved aside from flap creation. Temporary side effects include:

  • Hazy or blurry vision.
  • Trouble with night vision or driving at night.
  • Dry eyes.
  • Scratchiness or itchiness in the eyes.
  • Halos, starbursts, or glares around lights.
  • Light sensitivity.
  • Discomfort.
  • Small pink or red patches in the white of the eyes.

These typically go away after about six months. If they do not go away, start getting worse, or are accompanied by eye pain or discharge, contact your eye doctor immediately for help.

You are at low risk of severe side effects as IntraLase and other LASIK technologies improve, but there is still a small risk of adverse effects on your vision. These side effects are very rare and may include:

  • Corneal edema.
  • Lesions on the cornea.
  • Low eye pressure.
  • Trouble healing or scarring around the flap.
  • Glaucoma or cataracts.

Most people who undergo either traditional LASIK or IntraLase get 20/40 vision or better, with minimal side effects for a few weeks. Laser eye surgery technology has advanced significantly over recent decades, and is now considered one of the safest surgical procedures on the market.

Unless you are still an adolescent, have an unstable refractive error, have very thin corneas, or have an existing health problem, you should be a good candidate for either procedure. You may be more interested in one over the other, or your eye surgeon may recommend one over the other.

Work With Your Doctor

Optometrists and ophthalmologists debate whether IntraLase vs. LASIK is better. Both procedures are very similar, so the final decision comes down to your eyes and what your eye surgeon is trained to perform.

Both outpatient procedures have good success rates, cost about the same, and require little time for the operation and recovery. If you have questions about either operation or which might work better for you, ask your eye doctor.

 

References

LASIK: Know the Rewards and Risks. (July 2018). WebMD.

What Is All-Laser LASIK? Johnson & Johnson Vision.

LASIK – Laser Eye Surgery. (December 2019). American Academy of Ophthalmology (AAO).

How Does It Work? Johnson & Johnson Vision.

Transient Light Sensitivity a Minor Complication of IntraLase Use. (October 2004). Healio, Ocular Surgery News.

Facts About LASIK Complications. (December 2018). American Academy of Ophthalmology (AAO).

Important Safety Information. Johnson & Johnson Vision.