My LASIK research for hyperopia and astigmatism

What is LASIK?

LASIK (laser in situ keratomileusis) is a surgical procedure of the cornea of the eye that is done to improve your vision and tries to remove your dependence on eyeglasses. LASIK can be used to correct myopia, hyperopia and astigmatism. (more information on LASIK from the U.S. Food & Drug Administration “FDA”)

Are all LASIK procedures the same?

It is important to highlight that not all LASIK procedures are the same, during my research I found that although LASIK addresses the same 3 most common vision issues (myopia, hyperopia, astigmatism) that the degree of success and the way the surgery is actually executed varies from doctor to doctor.

So in reality it is hard to make an apples-to-apples comparison of LASIK as you may get a consultation from 3 different “top” doctors in your area and when you get down to the nitty gritty details of the procedure itself you discover that there are differences from doctor to doctor.

Sure the doctor is bringing in multiple years of expertise, he does XX amount of eye surgeries a week, has done over thousands of surgeries and even worked on celebrities. I am not here to discuss the doctor skills being different but the most important thing about this life changing operation: the Technology.

LASIK has changed a lot in the past 5 years, what you may not be aware is that there are several healthcare companies that design and build the laser machines and technology behind LASIK. While you may have the best skilled doctor in the field, if they execute your surgery using a laser technology that is 10 years old, you may not get the same results as getting the same surgery with a novice doctor using the latest in laser technology (more on this later).

Nowadays there are several advances in technology for the surgery that reduces doctor involvement and involves machines using sophisticated algorithms, similar algorithms to the ones the laser uses to correct your vision, but this time they use it to cut a flap into your cornea in what is called “bladeless LASIK” – in the past a doctor would manually cut your corneas for surgery using a blade called microkeratome to create the corneal flap.

Several clinical researches have been done and “bladeless” LASIK has been found to be more predictable and safer than the old manual process using the microkeratome. If you decide to get bladeless LASIK you are letting a machine using an algorithm to do the corneal flap, this is why even if you go to a novice doctor the flap would be the same from patient to patient since the doctor is not involved in cutting your eyeball manually. All he may do is make some minor adjustments to the software so the machine can do a more precise (or larger) incision depending on the pathology of your vision problems.

You can read more about bladeless or Femtosecond Laser LASIK (article), there is also a debate of two doctors with different opinions on bladeless vs. manual microkeratome process here.

On the next page, I discuss the equipment and different procedures like topography-guided ablation.