Either cutting the flap, or afterwards having some type of problem related to the flap.
All you have to do is a google search of images, and type in "lasik complications" and you will see that the vast majority of complications involve the flap in some way (eg, flap wrinkles, incomplete flap, dlk or inflammation
under the flap, epithelial ingrowth under the flap, etc)
therefore, by not cutting a lasik or intralase flap to begin with, you are eliminating 90% of all possible complications--meaning that, statistically, a no-flap procedure (such as lasek or prk
) must be 10x safer than an incisional one
the only downside to advanced surface ablations is that it takes a couple of more days to heal, and there is some very minor discomfort during those days. I had lasik myself (i was the 1st lasik surgeon in nyc to have lasik himself, way back in 1999 when there were no good alternative procedures), and can tell you that there is no pain at all, and you recover in 1-2 days. With asas, there is some minor discomfort and your surface heals, and it takes 3-4 days, which is double the time
i should have also been more precise in my survey of 100 eye
surgeons across the country who drove and flew in for the "updates in ophthalmology
" course given at cape cod, organized by a harvard and tufts-affiliated surgeon
of the 100 eye surgeons in the audience, i made them vote on which type of procedure they were now primarily performing. 90% said that they were primarily performing incisional procedures, ie lasiks and intralase, which was the expected answer
i then asked the following question:
"if you were forced to yourself undergo a refractive procedure now, either to get rid of your glasses
or contacts for distance or reading (many of them were in their 50s so in reading glasses), knowing what you do about possible complications, even if rare, which type of procedure would you have yourself?"
the answer to this question was both surprising and stunning, and even a bit disconcerting
90% of them voted the opposite direction--ie, they said if it were their own eyes, they would have a nonincisional procedure (lasek or epilasek, or if non-advanced, a prk)
when i asked them to explain this contradiction, they said things like;
"we know it's marginally safer to have a non-incisional surgery, but cannot convince the patients that a recovery that is twice as long (4 vs 2 days) is worth saving this low risk"
so it is true that the vast majority of eye surgeons in the us today are still doing incisional procedures, and it is also true that they will have excellent results without a major flap complication over 99% of the time, however, to get that success rate as close as possible to 100%, you really have to get a non-incisional procedure
thanks and hope this helps.