Femtosecond bladeless Lasik, is fast becoming the standard of care for patients who need vision correction, and do not want to wear glasses or contact lenses. Your doctor will help you make right choice, but chances are, Femtosecond Lasik will be it.
Femtosecond Lasik is blade free
Femtosecond Lasik is also called blade-free Lasik, all-laser Lasik, or bladeless Lasik. During conventional Lasik, your surgeon uses a mechanized knife called keratome to make a corneal flap. On the other hand, in Femtosecond Lasik, this is made by an ultrafast laser. Consequently, the surgery uses no blades or knives. This is also why it is a high precision surgery, with better results.
Advantages of Femtosecond Lasik
It is one of the premium laser vision correction surgeries for several reasons. These include:
- The procedure uses lasers for raising the corneal flap. Thus, the flap thickness is more controlled and predictable. Consequently the surgery is safer and more precise.
- It is associated with fewer flap related complications in the long term. Therefore, there is a reduced risk of corneal abrasions, flap loss etcetera.
- The surgery is completely bladeless. Because of this, pateints do not feel as anxious. There is no fear of a knife near the eye.
- Femtosecond laser is safer in thinner corneas. Since the flap is more predictable, it may be safer for correcting higher refractive errors also.
- The healing is faster because of the laser-cut flap. This also means better quality of vision after surgery.
- Fewer patients complain of vision problems like glare, ghost images and haloes around light sources.
Disadvantages of Femtosecond Lasik
Femtosecond Lasik also has a downside. These disadvantages include:
- Primarily, the biggest disadvantage of the surgery is its cost. This is because the Femtosecond laser is a highly sophisticated and expensive laser. In addition, the disposable equipment used for making the corneal flap also contributes to the higher cost.
- Flap related complications, though few, may occur. These include incomplete flaps, flaps with striae, and flap dislocation.
- Transient Light Sensitivity Syndrome (TLSS), may occur about two to six weeks after Femtosecond Lasik. The patient complains of increased light sensitivity. However, there is no change in vision. The condition resolves within a couple of weeks with eyedrops.
Are you a candidate for Femtosecond Lasik
Generally, if you are a candidate for conventional Lasik, you are eligible for Femtosecond Lasik also. You may discuss the option of the surgery, in case of the following:
- If you have mild/moderate myopia, hyperopia and/or astigmatism.
- In case your corneal thickness, as judged by your doctor, is adequate for correction.
- If you do not suffer from any eye or systemic diseases which may be a contraindication for the surgery.
- In addition to this, your doctor will perform a comprehensive eye examination to decide if you are eligible for surgery.
Contraindications for Lasik
- Autoimmune disorders, such as rheumatoid arthritis, SLE, Sjogren’s syndrome, Ankylosing spondylosis
- Immunosuppression due to medications or HIV
- Moderate to severe dry eyes
- Unstable vision
- Age less than eighteen
- Inflammatory eye diseases like keratitis, uveitis
- Moderate to severe glaucoma
- Pregnancy and lactation
- Corneal disorders like Keratoconus, corneal opacity or healed ulcers
Procedure and recovery time
Typically, you will spend half a day in your doctor’s office on the day of surgery. Even though the surgery takes about 10 minutes per eye, you will require time for the preparation. Usually, you can go back to your normal lifestyle, not long after the surgery. You will not be allowed to drive back on the day of surgery, so make sure you are accompanied by someone. Most patients get perfect vision the day after surgery. However, some patients may need a few weeks for the vision to become stable.
This article is a part of the LASIK Hub. Please also read LASIK Recovery Timeline, Are You Fit For LASIK?, Is LASIK Safe?, Bladeless LASIK, Lasik Side Effects: Incidence and Management,
Femtosecond Lasik: Bladeless Surgery, LASIK Eye Surgery: Are You a Candidate? What to Expect, and What to Ask, and PROWL: Listening to Lasik patients. Also useful is Second Opinion Before Eye Surgery
You may want to watch these videos to understand things better here, here, and here.
FAQs
Q. What is Femtosecond LASIK?
Femtosecond LASIK is an advanced blade-free laser vision correction procedure used to reduce dependence on glasses and contact lenses. A femtosecond laser creates a precise corneal flap before an excimer laser reshapes the cornea to correct refractive errors such as myopia, hyperopia, and astigmatism.
Q. How is Femtosecond LASIK different from conventional LASIK?
Traditional LASIK uses a mechanical microkeratome blade to create the corneal flap, whereas Femtosecond LASIK uses a laser. This allows highly precise flap creation and eliminates the need for a blade. The best procedure depends on individual eye characteristics and a detailed evaluation.
Q. Is Femtosecond LASIK painful?
Most patients experience little or no pain during the procedure. Numbing eye drops are used before surgery. Some patients may notice mild irritation, watering, or light sensitivity for a short period after treatment.
Q. Am I a suitable candidate for Femtosecond LASIK?
Suitable candidates are generally adults with stable spectacle numbers, healthy eyes, adequate corneal thickness, and realistic expectations. A comprehensive eye examination is necessary to determine whether Femtosecond LASIK is the most appropriate option.
Q. How long does recovery take after Femtosecond LASIK?
Many patients notice clearer vision within 24 to 48 hours. Vision usually continues to stabilize over the following days and weeks. Most individuals can return to normal activities relatively quickly, although recovery varies from person to person.
Q. Can Femtosecond LASIK permanently remove the need for glasses?
Femtosecond LASIK can significantly reduce dependence on glasses or contact lenses for many people. However, age-related changes such as presbyopia may still occur later in life, and some patients may occasionally require glasses for certain tasks.
Q. What are the benefits of blade-free LASIK?
Potential benefits include precise flap creation, rapid visual recovery, reduced dependence on corrective lenses, and treatment that is customised to the patient’s eyes. The exact advantages vary depending on the individual’s refractive error and eye health.
Q. What tests are required before Femtosecond LASIK surgery?
A LASIK evaluation typically includes a comprehensive eye examination, corneal mapping, corneal thickness measurement, tear film assessment, refractive error analysis, and detailed assessment of overall eye health. These tests help determine safety and suitability for surgery.
About the Author
This article was written by Dr Shibal Bhartiya, fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator, Clinical Director at Marengo Asia Hospitals, Gurugram, known for ethical, patient-centred glaucoma care and independent glaucoma second opinions. She is also the Program Director for Community Outreach & Wellness; and for the Marengo Asia International Institute of Neuro and Spine.
She has published peer-reviewed research on glaucoma management, examining how treatment decisions should balance medical evidence, patient preferences, and long-term vision outcomes.
As Editor-in-Chief of Clinical and Experimental Vision and Eye Research and Executive Editor of the Journal of Current Glaucoma Practice (Pubmed Indexed, official journal of the International Society of Glaucoma Surgery), Dr Shibal Bhartiya brings editorial and research depth to every clinical decision. Her 200+ publications, including 90+ PubMed-indexed publications and 28 edited textbooks span glaucoma biology, surgical outcomes, health equity, and emerging diagnostics.
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