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LASER EYE SURGERY: Femtosecond Laser or Microkeratome; Which is best?

Laser Eye Surgery depending on the patient and the outcome […]

By Published On: 24 February 20122.9 min read

Laser Eye Surgery depending on the patient and the outcome required can come in many forms.  By far the most common is LASIK.

If you’ve decided on LASIK to correct your vision, you’ve probably found out that there are many different types of laser eye surgery. Also, you’ve probably also found out there are a number of different instruments that can be used to complete the LASIK procedure.

One of the biggest debates among doctors, and, subsequently, among patients, is the use of the Femtosecond laser versus the microkeratome blade. A simple look at the differences between the two are presented below — from the perspective of patients and their doctors.

A Comparison, Side-By-Side

There are several reported differences between the use of the femtosecond laser and the microkeratome blade, by both doctors and patients. Below are several points to examine when considering LASIK surgery.

•    Discomfort levels. Some doctors have reported that patients seem to experience more feelings of pressure and discomfort during the procedure with the femtosecond laser than patients who have had the surgery with a microkeratome blade.

•    Recovery time. While recovery time with LASIK, both using a femtosecond laser or microkeratome blade, is similar. However, some patients report fuzzy vision for the first week or so with femtosecond, but not with microkeratome. However, there are some conflicting reports that femtosecond has faster visual accuracy recovery over microkeratome usage.

•    Length of time in surgery. The actual time in surgery with femtosecond usage is longer than with microkeratome blade usage.

•    Cost. Femtosecond is more expensive than microkeratome.

•    Accuracy of flap shape and completeness. Some doctors report that the flap creation is cleaner and sharper with femtosecond laser usage, and a thinner flap can be created with femtosecond lasers — the thinner the flap, the better the post-surgical outcomes.

•    Risks and complications. The difference in risks and complications is often said to be negligible. However, for patients with certain eye conditions, such as epithelial basement membrane dystrophy, a microkeratome blade is not advisable, and a femtosecond laser is the better choice.

•    Evolution of technology. Side-by-side, improvements of both the femtosecond laser and the microkeratome blade come along often enough to not put one too far ahead of the other.

Ultimately, finding a doctor you trust who uses the tools you want used on your eye is the important part. The treatment outcomes for both femtosecond laser use and microkeratome blades are similar, and have negligible differences in risk. In fact, the differences between femtosecond laser and microkeratome depend on physician and patient comfort and experience. When consulting with your eye doctor, you will want to take into consideration some of the following things:

•    Do you have any conditions that would make one piece of technology the superior choice over the other?

•    What kind of tools does your eye doctor or surgeon have the most experience with?

•    What kinds of complications have they seen with their patients, with both femtosecond laser usage, and microkeratome blade usage?

Dr Jim Kokkinakis has worked as a consultant and an optometrical educator in the largest Laser Vision Correction Centre in Australia for 6 years between 1996 and 2002.  During this time up until now he has seen thousands of patients that have had the procedure.  He is therefore very experienced in choosing the right procedure and the right laser Eye Surgeon for the appropriate patient.  Call us on 9290 1899 now to make an appointment to work out if Laser Eye Surgery is right for you.


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