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iLASIK vs LASIK: How to Choose

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What’s the difference between iLASIK and LASIK?

iLASIK is a newer iteration of LASIK, combining innovative technologies for an even more precise, personalized vision correction experience. Both procedures aim to reduce or eliminate the need for glasses or contact lenses by reshaping the cornea. However, they differ in terms of how the corneal flap is created and how the eye is mapped for treatment.

While few 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.

What Are LASIK and iLASIK?

While most people have a basic understanding of LASIK, iLASIK may not be as familiar. Both are modern, highly effective surgical techniques to correct refractive errors like nearsightedness, farsightedness, and astigmatism. The ultimate aim of both procedures is to improve vision and potentially eliminate the need for corrective eyewear.

LASIK: A Closer Look

LASIK is a type of refractive eye surgery that alters the shape of the cornea (the clear front part of the eye) to improve vision. First approved by the FDA in the 1990s, LASIK is the most common laser eye surgery today.

The process of LASIK involves creating a thin flap in the cornea using a microkeratome, a precise surgical instrument. This flap is then lifted to expose the underlying corneal tissue, which is reshaped using an excimer laser to correct the refractive error. After the reshaping, the flap is repositioned to its original location, where it naturally adheres and heals over time.

The key advantage of LASIK is its quick recovery time. Most patients experience improved vision within 24 hours of the procedure, with minimal postoperative discomfort.

iLASIK: An Advanced Technique

iLASIK, or IntraLase LASIK, is an advanced form of LASIK that integrates several leading-edge technologies for a highly personalized and bladeless LASIK procedure.

The iLASIK procedure begins with an in-depth imaging process of your eyes using wavefront technology. This technology creates a detailed 3D map of your eye, noting even the smallest imperfections (aberrations). This step is vital as it allows for a personalized procedure, as each person’s eyes are unique.

Next, instead of a microkeratome, iLASIK uses a laser to create a precise and thin corneal flap in a bladeless manner. The creation of the corneal flap with this laser reduces risks associated with the manual method and allows for a custom-fit flap based on the unique shape of each patient’s eye.

Finally, an excimer laser is used to reshape the underlying corneal tissue as per the 3D map obtained from the wavefront technology, thus correcting the refractive error. Once the reshaping is done, the flap is put back into place where it adheres naturally and heals over time.

The integration of wavefront technology and a femtosecond laser makes iLASIK a highly personalized, precise, and safe procedure. This customized approach is particularly beneficial for patients who might not be ideal candidates for traditional LASIK due to thin corneas or other complexities.

iLasik vs. LASIK: Pros and Cons

LASIK and iLASIK work for similar 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. So, why would you choose one procedure over the other?

Here are some pros and cons of each to help you learn which procedure may be better for you:

iLASIK Pros and Cons

Pros:

  • Highly precise: iLASIK uses an IntraLase laser to create the corneal flap, which is more precise and safer than the blade used in traditional LASIK.
  • Customizable: The procedure uses wavefront technology to create a 3D map of the eye, allowing for a highly personalized treatment plan.
  • Good for some complex cases: iLASIK can often be used for patients who may not be candidates for traditional LASIK, such as those with thin or irregular corneas.

Cons:

  • Cost: iLASIK typically costs more than traditional LASIK costs, primarily due to the use of more advanced technology.
  • Rare complications: Like traditional LASIK, there is a small risk of complications, including dry eyes, light sensitivity, or night vision problems. There is 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. 
  • Not for everyone: Despite being suitable for a wider range of patients, iLASIK isn’t for everyone. Some people, like those with severe dry eye syndrome or certain corneal diseases, might not be candidates.

LASIK Pros and Cons

Pros:

  • Proven track record: LASIK has been performed for several decades, and it has a proven track record of success and safety.
  • Quick recovery: Most patients experience a significant improvement in vision within 24 hours of the procedure and can return to their normal activities shortly thereafter.
  • Minimally invasive: The procedure is quick, typically taking about 10 minutes per eye, and requires only topical anesthetic drops.
  • Reduced dependency on eyewear: Many patients no longer require glasses or contact lenses after LASIK, although some may still need them for specific tasks such as reading or driving at night.

Cons:

  • Potential flap complications: Although rare, there is a risk of flap complications during and after surgery, such as flap dislocation or epithelial ingrowth, because the procedure uses a blade to create the flap.
  • Dry eyes: Some patients experience dry eyes after the procedure, although this side effect is usually temporary.
  • Not for thin corneas: Patients with thin or irregularly shaped corneas might not be good candidates for traditional LASIK. Also, 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.

How to Determine Whether iLASIK or LASIK Is Better

LASIK and iLASIK are fairly similar. It can be hard to determine which one is right for you. The bottom line is that your eyes will likely determine the best procedure for your needs.

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.

iLASIK vs. LASIK: Frequently Asked Questions

Is LASIK or iLASIK painful?

During the LASIK or iLASIK procedure, anesthetic eye drops are used to numb the eye, so you should not feel pain. You may experience a pressure sensation when the corneal flap is being created, and some discomfort, itching, or dryness in the eyes for a few days after the surgery. Your surgical team will advise you on how to alleviate these symptoms.

How long does it take to recover from LASIK or iLASIK?

Most patients notice an improvement in vision immediately after surgery, and vision usually stabilizes within a few weeks. However, it varies from patient to patient. Some people may see perfectly within 24 hours, while others may need a few days to a week. Strenuous activities and environments where eyes might get dirty or dusty should be avoided for at least a week.

How do I know if I’m a good candidate for LASIK or iLASIK?

The best candidates for LASIK or iLASIK are over 18, have stable vision for at least one year, and have a prescription that falls within the treatable range. Certain conditions like severe dry eyes, corneal diseases, or other health issues may disqualify some individuals. It’s also important that your corneas are thick enough for the reshaping process.

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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