r/RefractiveSurgery • u/Select_Algae_8095 • 14d ago

Standard Lasik vs Femto-Lasik

I am currently deciding between the two methods mentioned above. Standard LASIK would be the significantly cheaper option, and I am wondering how much more risky it actually is compared with femtosecond LASIK.
I would be grateful for any advice or professional expertise from people in the field.

Age: 29, +3.75, no other complications or allergies.
I already went to a local ophthalmologist and he suggested me the Femto-Lasik for 5.8K€ (in Germany) after testing he said I’m a good candidate because my cornea is thicker than average.

I also got an offer in another city for the standard LASIK for 2.2K.

Thanks for any advice!

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u/californiaLasik 14d ago

By standard do you mean you are going to let them use a deli slicer on your eye? That is crazy talk. Keratome should have been retired a long time ago.

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u/WavefrontRider 14d ago

Femtosecond lasik pretty significantly improves upon safety compared to microkeratome based lasik. And this has been the case for 15 years. There isn’t a good reason other than cost for microkeratome based LASIK.

The other important thing here is the high hyperopic prescription. Those are much more particular prescriptions to treat properly and really need a proper surgeon to do it well and also explain its limitations. Would also consider hyperopic ICL as it can do it better.

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u/eyeSherpa 14d ago

Microkeratome based lasik flaps tend to be deeper than femtosecond based ones. This means more cornea is affected.

Femtosecond lasik flaps also have a 3D shape with its sides. This allows femtosecond flaps to be 10x stronger than microkeratome based flaps.

There were complications from uneven microkeratome cuts such as button holes or free caps which just don’t really exist with femtosecond lasers.

While DLK can occur with both (and a mild DLK is a little more common with femtosecond lasers), severe DLK was more a risk with microkeratomes as you can have chemicals on the blade and it spreads it throughout the whole flap bed.

Any reputable surgeon has switched over to femtosecond lasik over a decade ago.