Which is Better: Blade or Bladeless Lasik?
If you are considering LASIK eye surgery, you might be wondering whether you should get blade or bladeless LASIK.
The terms "blade" and "bladeless" refer to how the eye surgeon creates the corneal flap during the LASIK procedure. Other than the flap creation, the surgeries are essentially the same.
Bladeless LASIK is a newer technique. In modern LASIK surgery, many surgeons choose bladeless over traditional LASIK.
However, this does not necessarily mean bladeless LASIK is always the better choice. Both forms of LASIK have advantages and disadvantages.
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What is Bladed LASIK?
Bladed LASIK, otherwise known as traditional LASIK, uses a surgical blade to create a corneal flap. This blade is called a microkeratome.
Cost
Bladed LASIK typically costs $200 to $400 less than bladeless LASIK. However, it is more common for people to require a secondary enhancement procedure.
Pros
- Often costs less than bladeless LASIK.
- Lower risk of diffuse lamellar keratitis, a complication that causes inflammation underneath the corneal flap.
- Less suction time required, which may be more comfortable for the person.
- May be a better option for some enhancement procedures, especially if you received traditional LASIK originally.
Cons
- Higher risk of decentration, which means the laser is not centered correctly on the eye. This can cause irregular astigmatism.
- Higher risk of flap complications such as flap wrinkles or irregular flaps.
- Higher risk of higher-order aberrations, which are light-related distortions that cause glare, halos, ghosting, and starbursts.
What is Bladeless LASIK?
Bladeless LASIK uses a femtosecond laser to create the flap. It is also known as “all-laser” LASIK.
Common equipment used during bladeless LASIK surgery includes iLASIK and Intralase. Many surgeons favor bladeless LASIK over bladed LASIK for its consistent results and excellent visual outcomes.

Cost
Bladeless LASIK costs about $200 to $400 more than a bladed procedure. This procedure results in fewer people needing enhancement procedures. Some people require a second "touch-up" LASIK procedure to further correct their vision.
Pros
- Creates more consistent corneal flaps, resulting in fewer flap-related complications.
- Creates thinner corneal flaps, allowing the surgeon to correct higher prescriptions with less corneal tissue.
- Lower risk of dry eyes.
- Better overall vision quality.
- Better night vision with less glare and halos.
- Lower risk of surgically-induced astigmatism.
- Vision improves slightly faster after surgery.
Cons
- Higher risk of diffuse lamellar keratitis, a complication that causes inflammation underneath the corneal flap.
- Higher risk of light sensitivity, but this side effect is usually temporary.
- Some surgeons charge more for bladeless LASIK, while others charge the same price as traditional LASIK.

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Brief Overview of LASIK Procedures
Laser-Assisted In Situ Keratomileusis (LASIK) is a type of refractive eye surgery. It provides vision correction for myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.
Before surgery, you'll have at least one or two consultations with your doctor. This helps determine if you're a good candidate for the procedure.
During LASIK, your surgeon will create the corneal flap using a microkeratome blade or a femtosecond laser. This helps correct vision problems by changing how light focuses on the retina.
The entire process only takes about 15 minutes for both eyes.

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Can I Combine Blade or Bladeless LASIK With Other Types of LASIK?
The short answer is, yes. Think of LASIK as a procedure that involves two steps. The first step is flap creation, and the second step is corneal reshaping.
The options for flap creation are:
- Microkeratome blade
- Femtosecond laser
The options for corneal reshaping are:
Conventional LASIK
This bases the treatment on your prescription. The laser corrects your vision by flattening your cornea. This may result in a higher risk of night vision problems such as halos or glare.
Wavefront-Optimized LASIK
This improves upon some drawbacks of conventional LASIK. Instead of simply flattening the cornea, wavefront-optimized techniques maintain your cornea’s natural curvature.
Wavefront-Guided LASIK
This customized LASIK procedure minimizes higher-order aberrations, resulting in higher-quality vision.
TopographyGguided LASIK
This customized LASIK procedure uses a topographer to map out your cornea in detail. These measurements allow the surgeon to customize a treatment that delivers sharper vision with fewer light distortions.
The options for flap creation and corneal reshaping may be combined in various ways. Your eye surgeon can help you determine which options are best for you.
Which Type of LASIK Is Best For Me?
Unfortunately, it is impossible to determine which type of LASIK procedure is best without medical guidance.
You'll need to call a LASIK center and schedule an appointment. Your doctor will ask you about your overall health, eye health, and your expectations for vision correction.
After this, your doctor can determine which type of technology to use during your eye surgery.
Summary
Blade or bladeless LASIK can be combined with other types of LASIK to provide vision correction. Aside from how the surgeon creates the corneal flap during the procedure, the two are essentially the same. Consult your eye doctor to know which type of LASIK is best for you.
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