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All LASIK is Not Equal

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Patient experience with LASIK can vary extensively based on laser centers, equipment, and surgeons.

It seems surprising then, that many patients believe that LASIK is the same no matter where they have their procedure and that the only variable between centers is cost. Nothing could be further from the truth. Differences include the accuracy of pre-operative measurements (which directly affects the postoperative visual results), blade vs. femtosecond laser flap creation, the lasers themselves and, of course, the surgeon.


Pre-operative accuracy of the correct prescription is paramount. Without an accurate doctor’s refraction (as opposed to technician refraction), results cannot be accurate.

Flap creation.

Surprisingly, some surgeons still use a blade for flap creation. Flaps created this way are typically much thicker than those created with a femtosecond laser, resulting in a lower margin of safety against ectasia (progressive thinning of the cornea that might end up requiring a corneal transplant) as well as greater problems with postoperative dryness.

Femtosecond lasers.

Yes, there is a difference in lasers. The femtosecond laser is used to create a corneal tissue flap. At Bennett & Bloom Eye Centers, we use the Zeiss Visumax Femtosecond Laser. This laser has several advantages over older, more dated femtosecond lasers. First, it provides a very comfortable experience for the patient. The docking interface is very gentle on the eye, and most patients report only a very slight pressure sensation and no pain whatsoever. Other lasers require the creation of strong suction over the cornea, which can be very uncomfortable. Second, the Visumax creates a beautiful and healthy-looking LASIK flap. This is important because a well created flap allows the surgeon to lift, and lower the flap with ease. This improves patient outcomes and post-operative discomfort. Finally, the Visumax is able to obtain ultrathin, 100-micron flaps for greater safety and comfort, providing for minimal, if any, post-operative dry eye problems.

Excimer lasers.

Differences in excimer lasers are greater than one would think. The Alcon EX500 is considered the gold standard, top of the line excimer laser for several reasons. First of all, it operates at 500 Hz, making it the fastest excimer laser on the market. This translates to quicker procedure times for the patient! Second, this laser uses Alcon’s Perfect Pulse technology, which means that each pulse is custom calibrated to sculp and treat the patient’s prescription. The eye-tracker system that Alcon uses is state-of-the-art; it is able to follow even the smallest eye movements should the patient move during the procedure. If the patient moves too much, the laser automatically stops, and will restart once they are back in position, thereby still allowing for extreme accuracy. All of this translates to better patient experience, and even better visual outcomes post operatively.

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Surgical skill.

For some reason, many people think that LASIK is performed entirely by the laser with little or no surgeon input. While the lasers are extremely important, surgeon control cannot be underestimated. In large part, positioning and centering the lasers are performed manually. Lifting and, most importantly, repositioning of the flap is entirely manual. This is extremely important, as malpositioned flaps lead to striae (a wrinkle or fold in the cornea) that can severely affect post-operative vision. Surgical skill is even more important since epithelial ingrowth under the flap is more likely with enhancements. Precise flap manipulation decreases that risk. Furthermore, when ingrowth or other complications do occur, proper surgical management is crucial.

Choosing your LASIK center.

As you can see, choosing where you have LASIK is extremely important. Technology is a significant consideration. At Bennett & Bloom Eye Centers, we have the most advanced lasers and equipment available. Still, the surgeon’s judgment, expertise, and hands controlling these instruments are the most important factors in achieving the results you expect. We will talk you through the entire process to explain what you can expect—before, during and after your procedure—to help you have the most pleasant and successful experience possible. If you are considering LASIK, please contact one of our highly trained counselors for more information. Bennett & Bloom Eye Centers…Go Where The Doctors Go!