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The surgical instrument that helps with precision work during the LASIK and ALK surgery is called the microkeratome. It is an instrument which was created with a blade that oscillates that was designed to use for creating the corneal flap in the procedure. While a human’s cornea normally varies from about 500-600 micrometers in its thickness, it is an instrument that helps in creating a flap ranging from 83-200 micrometers in thickness during the procedure. This amazing instrument has been making its way throughout the world while being used to cut the cornea flap. It is also being used for Descemet’s automated stripping for endothelial keratoplasty (DSAEK), its being used for the slicing of a thin layer in the back of the cornea being donated, after which, it is transplanted into the recipient’s posterior cornea.

The instrument was created and developed back in the 1950’s by José Ignacio Barraquer Moner and Cesar Carlos Carriazo. José Ignacio Barraquer Moner (January 24th, 1916 – February of 1998), as a Spanish ophthalmologist, he spent the majority of his life working in Bogotá, Colombia. He had been designated “Father of Modern Refractive Surgery.” Today, José Ignacio Barraquer Moner’s surgical techniques are being used in the ophthalmology communities all over the world.

In today’s world, there are many who are still struggling due to refractive errors such as nearsightedness, astigmatism, and farsightedness. These people are wearing thin for the need of more examinations for newer eyeglasses and contact lenses. This surgery is now a house name and there are even some people who are asking about it in regard to correcting their vision no matter what the problem with their eyesight may be. Luckily, this treatment has been developed just for these conditions, and this type of technology continues to improve while newer bladeless and the all- laser surgeries has begun to grow in popularity. People are wanting to know more about it, and just what it is. Instead of using a blade only for creating the incisions within the cornea, the bladeless LASIK uses lasers throughout the entire procedure. There is a possibility of the time it takes for healing to be reduced, of course, but it has not yet been conclusively shown in all studies that there are any differences of the two.

While performing the surgery, the doctor creates a very thin flap within the cornea using a device referred to as a microkeratome which has high precision blades that oscillates. Next it is reshaped by the rings that are connected to a small suction ring which is used for creating the flap of the cornea tissue and allows a laser to work on the lens. The ring is connected to the cornea, which applies a high pressure during the time the blades are creating the flaps. The procedure takes less than thirty minutes, which includes the preparation for the surgery as well. The patient will be given a local anesthetic, and during the surgery the eye is held open to keep the patient from blinking. Since back in the late 1990’s (at the time which the first LASIK surgery had been approved), this is the kind of device that has been used, with an extensive track record for safe surgeries and rapid recovery times.

Some of the advantages of Microkeratome:

  • It only takes approximately thirty seconds for the flap to be created.
  • The patient will not be moved from one room to another throughout the procedure as the entire procedure can be performed in the same room, unlike with the other LASIK surgeries.
  • Since microkeratome devices will be able to cut through any abnormalities as far as color and /or opacity, there are no concerns of having issues or needing to re-calibrate.
  • There are other systems that can be attached to the microkeratome for creating the epithelial flaps, including their removal.
  • Traditional LASIK has less occurrence of inflammation.
  • Traditional or rather microkeratome surgeries cost less!

There are risks involved with LASIK surgeries of all types, these include: infection, inflammation, vision problems may occur later (such as dry eyes, pain, and halos), and the cornea and/or lens could be damaged, however, these risks are very rare. Immediate improvement in vision after surgery, in fact most people are able to return to their place of work within two days. As with the bladeless surgery, the traditional surgery may be need for another treatment further down the road, which is referred to as a revision/enhancement surgery. The benefits from either one of these two types of surgeries, including the detriments from both, the bladed or the bladeless, are going to have end results that are the same. A study that was performed in the year of 2015, has shown that there are not any statistical differences of any significance in the length of their healing time, the return of one over the other in visual acuity, or infection rate.

The decision comes down to what the patient and their eye surgeon decide on. A lot depends on whether or not they are equipped with the bladed LASIK, or if they are recommending one type over the other. More importantly is whether or not one’s insurance covers this type, the insurance company may cover the other type and not this one, and they may cover both, or none at all. It is also important to learn the differences between the two, the traditional (uses blades) and the newer LASIK (bladeless), prior to making a decision on having surgery by either one of them.

Both, the bladeless surgery and the traditional surgery is going to use a laser at some point during the surgical procedure for the correction of refractive errors.

The following are some of those:

  • Astigmatism: When the shape of the eye leads to other problems that refract the light towards the retina.
  • Presbyopia: This includes farsightedness which is due to the aging process.
  • Farsightedness: (hyperopia)
  • Nearsightedness: (myopia)