Posted in Patient Education, Resources, Technology

Bladeless vs Blade LASIK - Dr. McGarity performing LASIK surgery

Author: Dr. Josia Leipholtz

Anyone interested in LASIK surgery to improve the quality of their vision has probably come across the terms “blade or bladeless LASIK” during their research. Blade LASIK may sound intimidating, while bladeless LASIK may sound a bit like… magic. But, what is the difference between the two procedures and what are the potential benefits of each?

To find the answers we consulted with the friendly experts at Restoration Eye Care who gave us a “behind the scenes” look at how the Midwest’s premier ophthalmologists view both blade and bladeless LASIK.


Blade vs. bladeless: How do they work? How are they different?

To understand the difference between blade versus bladeless LASIK, we need to first understand the basics of how LASIK functions: No matter which type of LASIK you choose blade or bladeless (more typically called “all laser”), an expert surgeon will use an instrument to cut a thin, hinged flap into the cornea. This flap is then lifted as laser energy reshapes the eye, resulting in corrected vision. The flap is then re-positioned to promote faster healing.

The difference between blade and bladeless LASIK is the instrument (or tool) the ophthalmologist uses to create this flap. Blade LASIK uses a microkeratome (the blade), while bladeless LASIK uses another (IntraLase) laser to produce the incision and create the LASIK flap.


Bladeless vs Blade LASIK - 6 steps: (1) numbing drops, (2) flap creation, (3) flap lifted, (4) laser sculpting, (5) flap re-positioning, (6) in myopia, final corneal curvature is flatter

Potential Benefits

Most modern surgical practices (including Restoration Eye Care) no longer offer microkeratome (blade) surgery. Despite the name, some patients find blade LASIK more comfortable as the suction used in a microkeratome procedure lasts only about three seconds while suction using IntraLase can last between 15 to 20 seconds.

Still, the difference is negligible and because IntraLase flaps are typically thinner and more accurate, bladeless LASIK makes it much less likely that there would be a flap complication or incomplete flap. Bladeless LASIK also tends to allow easier flap lifts as a result of these IntraLase flaps.

Blade vs. Bladeless LASIK: Which is more painful?

And now the answer to the question that everyone wants to know: They are basically the same! The patient may feel more pressure with the microkeratome (blade) procedure, but neither is particularly painful.

Then why don’t modern practices offer blade surgery?

For the reasons mentioned above and because blade LASIK is an older technology. Bladeless LASIK is safer and more accurate, but it should be noted that the difference is largely in the marketing (as both create an incision in the cornea) and that blade LASIK uses an automated blade, not a scalpel.

Recovery time for blade vs. bladeless LASIK?

Recovery is also the same for both. Typically about one week, with dryness and slight vision fluctuation lasting up to a month at most. Of course, this can vary greatly depending on the patient and other complicating factors.

What kind of follow up & appointments are required for each?

Follow up for both forms of LASIK would be required at:

  • One Day
  • One Week
  • One Month
  • 3 Months
  • One Year

At Restoration Eye Care patients are covered for follow up for the entire first year after their surgery.

Is there a difference in terms of cost?

In general bladeless LASIK costs around $4,000 for bilateral (both eyes, usually done on the same day) surgery. Blade LASIK may be slightly cheaper, with about a $300 per eye difference.

At Restoration Eye Care we offer all laser iLASIK, including one year follow up, and any enhancement (if needed) within that year. Plus initial evaluations are always free.


Which should you choose?

As with all health decisions it all comes down to whichever is best for the patient. Bladeless LASIK offers the safest, most consistent technology for the procedure, but other health complications, like glaucoma, can affect which decision is right for you. The next step when considering any form of vision enhancement is to consult with an expert to determine which solution is right for you.

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