Vision by Pacific Cataract and Laser Institute

LASIK Flap Options

Two Flap Options

Accurate creation of the corneal flap is an important part of the procedure. Two options are available—a bladed flap and a laser flap. Our surgeons are highly skilled and experienced with both techniques, but the choice is yours.

  • Bladed Flap
    A precision, automated instrument called a microkeratome separates layers of corneal tissue to create a hinged flap. No tissue is removed and the procedure generally takes less than 10 seconds. Bladed flaps feather out and become thinner along the edge.
  • Bladeless Flap
    A femtosecond laser (different than the excimer laser used to reshape the eye’s surface) evaporates a microscopic layer of tissue within the cornea. In about 20 seconds, millions of interconnected bubbles are made to form a hinged flap. Laser flaps are more square along the edge.

 

 

Questions and Answers 

  • +ARE THIN LASIK FLAPS IMPORTANT?

    Yes. Thin LASIK flaps measure about 100 microns and are the least disruptive to corneal strength. They also preserve more underlying tissue for the vision correction stage of treatment. Most corneas are between 500 and 600 microns thick. To maintain corneal stability and avoid serious complications such as ectasia (a thinning and irregular bulging of the cornea that disturbs vision), our careful and conservative surgeons leave as much untouched cornea under the flap as possible.

  • +ARE LASER FLAPS THINNER THAN THOSE CREATED WITH A BLADE?

    They are with most LASIK centers but not at Pacific Cataract and Laser Institute. Our LASIK flaps made with a blade or a laser are usually about 100 microns—the thickness of a piece of paper.

  • +DO LASER FLAPS HAVE FEWER COMPLICATIONS?

    Yes. Although we have an excellent bladed flap technique, laser flaps are slightly safer in two ways:

    1. They have less risk of accidentally being made without a hinge.

    2. The squarer edge architecture of laser flaps is less vulnerable than the feathered edge of bladed flaps to epithelial ingrowth, a complication that occurs when eye surface cells invade the area under the flap.

  • +DO LASER FLAPS COST MORE?

    Yes. There is an additional fee for laser flaps. Femtosecond lasers are very expensive instruments with substantial maintenance costs. Also, surgeons must pay a fee to the laser manufacturer for every procedure.

  • +DO YOUR DOCTORS PREFER LASER FLAPS?

    Our doctors like laser flaps because they are less risky to make and less vulnerable to complications as the eye heals. However, we are supportive of those who wish to have bladed flaps for cost savings and convenience.

  • +ARE THERE DIFFERENT NAMES FOR THE LASER FLAP TECHNIQUE?

    Yes. Surgeons often use terms like bladeless, blade-free and all-laser LASIK to promote this option. Femtosecond laser manufacturers have also coined names such as IntraLase, iLASIK and zLASIK for the flap procedures done with their instruments.

  • +ARE ALL FEMTOSECOND LASERS USED FOR LASIK FLAPS THE SAME?

    No. Just as the numbers of pixels in digital cameras have greatly increased, so has the speed (frequency) of some of the newest femtosecond lasers. The laser we use to create LASIK flaps has an operating frequency more than 300 times faster than the femtosecond laser used by the majority of LASIK surgeons nationwide. The higher the frequency, the smaller the corneal cavities (bubbles) are and the closer they are together. In addition, the level of energy per pulse is much lower in some of the newest femtosecond lasers—which results in smoother laser incisions.

More Information
If you have more questions about LASIK flaps, call our refractive surgery counselors at 800-884-7254.