LASIK vs. Advanced Surface Ablation - What is the Difference?

By Jeffrey Martin MD

Published on March 17, 2010

Laser vision correction has come a long way over the past decade. Years ago, laser vision correction ablations were less precise, which made excellent results more difficult to obtain. According to Dr. Jeffrey Martin, metal microkeratomes were the gold standard for creation of the corneal flap during laser vision correction surgery and flap complications were not uncommon. The laser had to be centered manually and tracking eye movements could be difficult in some cases. New developments in the laser vision correction field make LASIK and surface ablation procedures safer and more effective than ever before.

Custom, Bladeless LASIK

Today, Dr. Jeff Martin offers all custom and bladeless laser eye surgery. In LASIK, we use Intralase, which is a blade-free laser that makes a safe, thin, and precise flap. The step of the LASIK procedure provides the patient with an added measure of safety due to the fact that no blade is necessary. Laser energy creates a layer in the cornea that is easily dissected into a flap. This flap is then lifted and custom LASIK correction is performed.

With CustomVue LASIK by VISX, a WaveScan is used to create a custom fingerprint of each patient's vision. The laser automatically centers and tracks eye movements, and uses iris registration to accurately place the ablation on the visual axis.

Advanced Surface Ablation

However, LASIK is not always the obvious choice in laser vision correction. By using corneal pachymetry and corneal topography, we sometimes determine that advanced surface ablation procedures, such as PRK, Epi-LASIK, or LASEK, are the better choice. Keeping the vision correction more superficial is sometimes advantageous in patients with thin corneas, irregular corneas, high prescriptions and dry eyes. When preserving corneal thickness is key, advanced surface ablation can be safer. Of course, there are certainly some patients that should have no form of laser vision correction. In our Long Island LASIK practice, about 70 percent of patients have LASIK and about 30 percent have PRK, LASEK, or Epi-LASIK.

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