Mechanical microkeratome LASIK
Traditional LASIK eye surgery
The pioneering method of laser vision correction, and the cornerstone of laser eye surgery for decades. Newer options exist, but traditional LASIK still holds significant merit for specific patient needs, often at a lower cost.
The basics
What is traditional LASIK?
Traditional LASIK (laser-assisted in situ keratomileusis) corrects vision issues in two primary steps: creating a corneal flap, then reshaping the underlying corneal tissue with an excimer laser.
The difference from all-laser LASIK is the flap: here it’s created with a mechanical microkeratome, a precision instrument with a small oscillating blade designed to carefully lift a thin flap of corneal tissue.
What it corrects
- Nearsightedness (myopia)
- Farsightedness (hyperopia)
- Astigmatism
The mechanical microkeratome
Operating with an oscillating blade, it creates a precise, ultra-thin corneal flap, which is then lifted to allow for the corneal reshaping. The technique has been the cornerstone of laser eye surgery for decades.
Why choose it
Benefits of the mechanical microkeratome technique
A reliable, cost-effective option with a long history of success:
Proven track record
Used extensively for many years, with a long-standing record of safe and effective results across a wide range of refractive errors.
Less costly
Typically more cost-effective than femtosecond laser methods. A more affordable option without sacrificing quality.
Shorter procedure time
A generally shorter flap-creation time contributes to a quicker surgical process, reducing anxiety and time under the instruments.
The procedure
How does traditional LASIK work?
Four steps, from evaluation to a flap that heals naturally without sutures.
Preoperative evaluation
A thorough examination determines your cornea’s thickness and shape, using advanced imaging and diagnostic tools to identify any conditions that might increase surgical risks.
Corneal flap creation
The mechanical microkeratome is carefully aligned on the corneal surface. Its oscillating blade creates a hinged flap in the cornea, exposing the stromal layer underneath.
Laser reshaping
An excimer laser reshapes the corneal stroma, precisely correcting the refractive error so the eye focuses light correctly on the retina.
Flap repositioning
The corneal flap is repositioned and adheres naturally without sutures, promoting faster healing and minimizing discomfort.
Am I a candidate?
Who’s a good fit for traditional LASIK.
A thorough evaluation determines candidacy. Patients with particularly thin corneas or irregular corneal topographies may be better suited to procedures like PRK, which don’t require a flap.
- Sufficient corneal thickness. The cornea must be thick enough to create a flap and still leave enough tissue for reshaping.
- A stable prescription. The best candidates have had a stable vision prescription for at least a year, ensuring the refractive error is not still changing.
- No history of corneal disease. Those without a history of corneal disease or keratoconus are typically good candidates for this surgery.
Safety insights
Understanding the risks
The mechanical microkeratome is safe, but it’s essential to understand both the risks and benefits before proceeding. These are the potential complications specific to the technique:
Flap complications
Irregular edges or incomplete flaps are possible with a mechanical blade, though advances in microkeratome design have significantly minimized these risks.
Epithelial ingrowth
In rare cases, epithelial cells may grow beneath the corneal flap and require removal. This complication is more common with mechanical flap creation, but it’s effectively managed when detected early.
Dry eye syndrome
Some patients experience temporary dry eye symptoms post-surgery, often resolving over time with lubricating eye drops and other therapies.
How does it compare to femtosecond lasers? The key distinction is the precision of flap creation: femtosecond lasers offer enhanced accuracy in flap depth and diameter, potentially reducing flap-related complications. Mechanical microkeratomes, when used by skilled surgeons, have demonstrated similarly positive outcomes, particularly for patients whose corneal characteristics suit the technique.
Recovery
Postoperative care and recovery
Recovery is generally quick, with most patients experiencing significantly improved vision within 24 to 48 hours. Following your care instructions is critical for optimal healing. See the full aftercare guide.
Use your prescribed drops
Antibiotic and anti-inflammatory drops prevent infection and minimize inflammation; artificial tears relieve dryness.
Protect your eyes
Avoid rubbing your eyes, which could dislodge the flap. Protective eyewear is recommended for the first week, particularly during sleep.
Keep your follow-ups
Scheduled visits confirm proper healing and let your surgeon monitor for complications like flap dislocation or infection.
References
- American Academy of Ophthalmology. (2023). Creating LASIK Flaps: Femtosecond Laser vs. Mechanical Microkeratome. aao.org (opens in a new tab)
- Nordan, L. T., Patel, R. S., & Kim, J. H. (2022). Comparative Outcomes in LASIK Flap Creation: Mechanical vs. Femtosecond Techniques. Journal of Refractive Surgery, 38(9), 1234-1242.