1. Precise cutting of the corneal flap with the FemtoSecond 200 Laser

LASIK technicians preparing for femtosecond laser creation of a flap

For patients who have had reservations about conventional LASIK because it involved the use of a blade to cut the corneal flap (the first step in LASIK surgery), the latest innovation in LASIK is called 100% Blade-Free LASIK (you may also hear it referred to elsewhere by other names such as IntraLASIK, Femto-LASIK, All-Laser LASIK, or IntraLASE). It is an all-laser, 100% blade-free procedure delivering unprecedented safety and better overall vision.This method replaces the hand-held microkeratome blade used in creating LASIK corneal flaps with a computer-guided, ultra-fast femtosecond laser.

Wills Laser Vision is the only practice in Central New Jersey to offer this higher standard of care, the fifth and latest generation Alcon FemtoSecond 200 laser which provides a more comfortable and quicker experience for patients. It is more gentle and accurate than previous generations of blade-free flap makers.

The advantages of 100% blade-free LASIK are significant and include:

  • BETTER VISION: Patients achieve statistically better vision with LASIK using the 100% Blade-Free LASIK method and, in many cases, better than 20/20.
  • IMPROVED SAFETY: Virtually eliminates potential flap complications.
  • THINNER FLAPS: Patients previously not considered to be candidates for LASIK due to thin corneas may now be treatable with the 100% Blade-Free LASIK method.
Actual video showing the creation of a perfect LASIK flap in only 6 seconds

2. Sculpting the cornea with the EX-500 Excimer Laser

One the corneal flap is cut, it’s time to perform LASIK surgery by sculpting the corneal surface. Unlike other lasers that focus solely on the front center surface of the cornea, the EX-500 Excimer laser addresses the unique 3-dimensional shape of your cornea. This advanced eye tracking and treatment enables us to minimize distortions that affect glare and night vision.

Your eye movements are tracked and mapped every few milliseconds to allow the internal mirrors of the EX-500 Excimer laser to align precisely with your cornea’s imperfections. The beams of light sent from the laser are strategically released to your cornea as the position of your eye movements change from millisecond to millisecond delivering the pulses of laser light 50 times faster than other laser systems. Each individual pulse of laser light is more fine and more delicate than before, and is more accurately placed because of the superior tracking system. The duration of the treatment is dramatically reduced and the result: unmatched accuracy and unmatched precision.

Actual video of the excimer laser sculpting the cornea in real time. The procedure takes only 10 seconds.

The advanced technology of the EX-500 Excimer laser provides us with the capability to produce larger optical zones, which means better results for patients with night vision issues and for patients with large pupils. Your pupil adapts to darkness by growing larger to allow in more light. The expanded optical zone enabled by the EX-500 Excimer laser compensates for these changes and provides better night vision than ever before.

As trusted physicians, we have embraced this new technology to offer you the very best of care. In addition to the benefits of 100% blade-free LASIK, the EX-500 Excimer laser also provides:

  • ACCURACY: We are able to use the EX-500’s advanced eye tracking system to measure light as it passes into the eye and then is reflected back. Five hundred times a second, the tracker creates an optical image of the eye, showcasing its flaws. Finer pulses of laser light are used to sculpt the cornea more gently, more rapidly and more accurately. Minute corneal imperfections are treated.
  • CUSTOMIZATION: As a result of these exacting measurements, we can now customize the LASIK procedure according to your unique vision correction needs like never before.
  • SATISFACTION: Clinical results report both near and far-sighted patients noted improvement to light sensitivity and night driving glare. The vast majority of patients report vision at least as good as, if not better than the vision they had with glasses and contacts before treatment.

100% blade-free technology is clinically proven to be safer and most accurate. With the addition of an ultra-sensitive tracking system and the EX-500 laser you get superior accuracy and unmatched precision. Wills Laser Vision at Princeton is the only center in this area with these advanced capabilities for LASIK.

The time is now. You don’t have to delay your dream of freeing yourself from glasses and contacts. Special payment plans and financing options are available through our office.

The 100% Blade-Free LASIK Surgery Procedure

Prior to your surgery, a thorough eye examination is done to determine your refractive error, current vision prescription and best corrected vision. “Best corrected vision” is the last time on the eye chart that you can see clearly with your glasses or contacts. Your outer eyes are checked for infections, eyelid abnormalities and tear duct problems. Your pupils are measured and your eyes are checked for glaucoma. Your eyes may be dilated and are examined for cataracts and retinal diseases.

Sophisticated instruments including corneal tomography, topography, aberrometry, and visual alignment analysis create a detailed 3-dimensional construction of your eye. This analysis tells the surgeon how to program the laser for your specific cornea.

On the day of your surgery, you will lie down in a reclining chair in our outpatient surgical suite in Princeton, New Jersey. You may be given a tranquilizer and while you relax, your eyes are numbed with drops of an anesthetic. A device is placed between your upper and lower eyelids to keep them open and prevent blinking.

Your eye will be moistened and a gentle suction ring will be placed on the eye. This ring keeps the eye from moving during surgery. At certain points your vision may become dim or blurred.

A paper-thin flap of corneal tissue will be created using the femto-second laser, using millions of microscopic bubbles beneath the surface of the cornea. During this part of the procedure patients will feel pressure on the front of their eye. There is no other sensation, and the process lasts only a few seconds.

After removing the suction ring, the flap is folded back to expose the cornea. Your vision will fluctuate as the flap is manipulated.

The laser is positioned over the eye while you stare at the fixation light above you. Utilizing the pre-programmed information about your eye which was obtained during your first visit, the computerized laser releases tiny pulses of ultraviolet light to gently reshape imperfections in the exposed corneal tissue (stroma).

During this process, a “tracker” will follow small movements of your eye and make continual adjustments to keep the laser centered over your visual axis. If the tracker senses a large movement, it immediately turns the laser off before the next pulse. If this happens, the laser is simply re-focused and the treatment will pick up where it left off.

After the laser light reshapes the stroma by vaporizing microscopic pieces of tissue, the flap is placed back into position and the edges are smoothed down. Within two to three minutes the flap adheres without stitches and healing begins. A see-through shield is placed over the eye to protect the flap.

The procedure is painless and takes approximately 1 minute. Some people experience a sensation of pressure when the eyelid device and suction ring are placed on the eye.

Here are some of the more common questions regarding 100% Blade-Free LASIK:

What are my options if I am not eligible for 100% Blade-Free LASIK?

For a certain segment of the population LASIK is not an option, most commonly due to the cornea being relatively thin. For these patients, “surface treatments” such as Photo-Refractive Keratectomy (PRK) can accomplish the same goals. This procedure removes the thin top layer of skin (epithelium) so the surgeon can do the sculpting on the front surface of the “clear cartilage,” or main component of the cornea.  The surgeons at Wills Laser Vision are experienced in all forms of refractive surgery, and use the safest variation with the quickest healing and least pain.

What’s the difference between 100% Blade-Free LASIK and other names I’ve heard like iLASIK, zLASIK, Femtec, VisuMax, intraLASE, All-Laser LASIK, and intraLASIK?

These are all different brand names to describe other “bladeless” LASIK systems. In our office, we use the Alcon FemtoSecond 200 laser, the fifth and latest generation of laser which provides unprecedented precision and safety.

Do patients have a preference between traditional LASIK and 100% Blade-Free LASIK?

In a survey of clinical practices, the vision in 100% Blade-Free LASIK treated eyes was preferred up to 3 to 1 by patients over the vision in the mechanical blade-treated eye (among those who stated a preference).

Will I get better results with 100% Blade-Free LASIK?

In a clinical study comparing the 100% Blade-Free treatment to the leading microkeratome, more patients achieved optimal vision in standard and custom LASIK surgery when the 100% Blade-Free method was used to create the corneal flap. New science reveals that the first step, creation of the corneal flap, has been underestimated for its effect on LASIK outcomes. Surgeons have found statistically and clinically significant differences in the vision patients achieve — better than 20/20 to 20/15 and even 20/12.5 — when the laser is used to make the corneal flap.


Additional reading

What happens after LASIK surgery?

How long will my vision be blurry after LASIK or PRK?

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