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iLASIK vs LASIK: How to Choose

Home / Laser Eye Surgery Guide 2023 / iLASIK vs LASIK

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If you want laser vision correction, you might ask your optometrist about LASIK, but many practices offer newer variations on this procedure like iLASIK.

You may be a better candidate for iLASIK if you have naturally thin corneas. In some cases, you may want to avoid potential side effects like transient light sensitivity syndrome (TLSS), so traditional LASIK might be a better choice for your eyes.

While little differences make iLASIK vs. LASIK a choice to debate, both procedures involve an excimer laser reshaping your cornea, similar recovery procedures and timelines, similar side effects, and similar costs.

The only way to determine if you would benefit from one of these outpatient procedures over another is to ask your optometrist or ophthalmologist about iLASIK vs. LASIK.

iLASIK vs. LASIK: Choosing Between Subtle Differences

woman undergoing lasik procedure

Laser vision correction has been an important option for people with refractive errors for decades. LASIK was the first laser-based procedure to be approved in the United States by the Food and Drug Administration (FDA) in 1999. Since then, variations on this operation have allowed for greater refinements in the basic operation’s success.

Reshaping the cornea with surgical tools has helped numerous people, but the laser-guided version was not introduced until the 1990s. Medical technology using lasers has allowed for more precise shaping of the cornea so you can achieve 20/40 visual acuity or better in a short amount of time after the procedure.

Lasers allow for faster healing times and faster surgical procedures. Less time is spent in the operating room, you spend less money, and you see better, sooner.

Variations on LASIK have led to operations like iLASIK. These procedures have a lot in common, but they also have important, subtle differences. With a little research, you can understand whether one of these procedures might benefit you more than the other.

The Pros & Cons of iLASIK vs. LASIK

LASIK and iLASIK work for essentially the same groups of people: adults (ages 18 years old and up), with stable refractive errors and otherwise healthy eyes. Both procedures can help people who are nearsighted, farsighted, or have astigmatism.

The major differences come down to parts of the surgical procedure, and some of the benefits and detriments between iLASIK vs LASIK.

iLASIK

This is a newer procedure that uses lasers to create a corneal flap and reshape the cornea. This is considered less invasive than traditional LASIK. It is simpler to customize than traditional LASIK, with better results for the shape of your cornea.

You will receive numbing eye drops and a device that holds your eyes open. Then, the Johnson & Johnson IntraLase laser will create a flap in your cornea. This can be thinner than traditional LASIK flaps.

You will then be moved to an excimer laser, which reshapes your cornea. Once the excimer laser has removed corneal tissue, the flap is put back in place, and you are moved into a recovery room for about an hour before you go home.

  • Pros: iLASIK allows for greater precision at all stages, which permits more people to undergo this type of laser vision correction. In traditional LASIK, people with thinner corneas are not good candidates. Since iLASIK makes a thorough map of your cornea first and then uses a laser to make a more precise, thinner corneal flap, people who have naturally thinner corneas can get better results.
  • Cons: Since the IntraLase device is a patented machine for this patented procedure, your doctor will need to be trained on it specifically in order to perform iLASIK. This means you might have a harder time finding someone who understands this device, compared to eye surgeons who can perform traditional LASIK. This also means iLASIK will be more expensive. There is also a small risk of developing a condition called transient light sensitivity syndrome (TLSS). An older medical study found that TLSS was associated specifically with the iLASIK procedure, occurring in about 1 percent of those who underwent laser vision correction with the IntraLase device. The condition resolves with a course of steroids, according to a study, and Johnson & Johnson made changes to the IntraLase device to lower the chances of the syndrome developing. Advances in LASIK technology have made complications like these more and more rare.

LASIK

The most widely recognized laser vision correction procedure in the world, LASIK was one of the original outpatient procedures that used lasers to reshape the cornea.

Traditional LASIK involves a bladed device called a microkeratome to create a thin flap in the cornea, allowing the excimer laser to remove corneal tissue. Although some doctors prefer the microkeratome, the device does require a certain thickness to your corneas, or you will not be a good candidate.

  • Pros: The traditional LASIK procedure has been performed on millions of people for decades, so it is well understood, easy to train eye surgeons to perform, and easily accessible to people who want long-lasting vision correction. It only takes about 15 minutes per eye to complete, and your eyes will be close to healed within a few days of the procedure. More eye surgeons are trained in the microkeratome device too. This helps to lower the cost for you, as an individual consumer, and it means you have fewer risks from undergoing a less familiar procedure using a patented, specific device.
  • Cons: People who have naturally thin corneas are not good candidates for LASIK. People who had LASIK but had their vision undercorrected, or whose refractive error continued to change, are unlikely to be good candidates for traditional LASIK.

Similarities Between iLASIK & LASIK

laser eye surgery

Since LASIK and iLASIK are very similar procedures, there is overlap in the types of people who are not good candidates for these operations, who qualifies, and how they work. For both iLASIK and LASIK, qualifications include:

  • You must be at least 18 years old.
  • Your refractive error must be stable and has not changed much in the past year.
  • You must not have severe, chronic dry eye.
  • You must have otherwise healthy eyes. People with glaucoma, cataracts, keratoconus, or eye infections are not good candidates.
  • You must not be pregnant or nursing.
  • You must be otherwise healthy in general. Diseases like diabetes can lead to problems healing.

Before either iLASIK or LASIK:

  • You will undergo a thorough eye exam to ensure the health of your eyes.
  • Your eye doctor will measure and map the surface of your cornea.

During either procedure:

  • Your eyes will be numbed with special eye drops.
  • A device will make a flap in your cornea.
  • An excimer laser reshapes your cornea.

After the procedure:

  • You will stay in recovery for about an hour following the surgery.
  • You may have temporary side effects like dry eyes, blurry vision, or glares or halos around lights.
  • You will have a follow-up visit the next day, and you should be able to return to work.
  • You should avoid intense exercise like running or swimming.

Your doctor can give you more information on how to care for your eyes after the procedure. Go to all follow-up visits. Let your eye doctor know if you have any symptoms like pain or bleeding, or if the side effects get worse or do not go away.

Your Eyes Determine Whether iLASIK or LASIK Is Better

The cost of both LASIK and iLASIK can vary depending on where you live, which specialist you go to, and if you can get some vision insurance coverage. Generally, both operations cost between $2,000 and $3,000 per eye.

You may think you are a better candidate for iLASIK, or you wonder if you can save money by opting for traditional LASIK. Work with your optometrist or ophthalmologist to determine which outpatient procedure works better for you.

This process will start with a thorough eye exam, so the eyecare professional can understand the state of your eye health as well as your vision. From there, you can discuss how both LASIK and iLASIK would look for your particular situation.

References

  1. Looking Back: The History of Laser Vision Correction. (July 2013). LASIK.com.
  2. What Is iLASIK Treatment? Back in Focus, Johnson & Johnson Vision.
  3. “Blade Versus Bladeless” LASIK Debate. (June 2016). All About Vision.
  4. Transient Light Sensitivity a Minor Complication of IntraLase Use. (October 2004). Healio, Ocular Surgery News.
  5. LASIK. (March 2018). U.S. Food and Drug Administration (FDA).
  6. LASIK Eye Surgery. (March 2018). MedlinePlus.
  7. LASIK – Laser Eye Surgery. (December 2019). American Academy of Ophthalmology (AAO).

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