Femtosecond laser flap creation: why the blade is history

The old microkeratome blade has been replaced almost entirely by femtosecond laser flap creation.

Why it matters

As a UK-trained consultant ophthalmic surgeon, I am asked about 'femtosecond laser LASIK' in almost every clinic. The honest answer is rarely the one people read online, and it always depends on the specifics of the individual eye.

The important thing to remember is that the eye is a paired organ, and decisions about femtosecond laser LASIK are decisions about the rest of your visual life, not just a single procedure or a single symptom.

What the evidence shows

Modern peer-reviewed evidence on femtosecond laser LASIK is stronger than it has ever been. Long-term follow-up studies from the Royal College of Ophthalmologists, the American Academy of Ophthalmology and large European cohorts all point in the same direction: careful patient selection matters more than any single piece of technology.

In practice, this means the same procedure can be an excellent choice for one patient and completely wrong for another. That is why my consultations always start with diagnostics, not with a recommendation.

What I explain in clinic

When I discuss femtosecond laser LASIK with a patient, I cover four things: what the procedure or condition actually is, what the realistic outcome looks like, what the risks are, and what alternatives exist. If any of those four are missing from a consultation you have had elsewhere, please ask.

I also try to be explicit about what a procedure will not do. Managing expectations honestly is one of the most important parts of a consultant's job.

Common questions

The three questions I hear most often about femtosecond laser LASIK are: how long does the effect last, how quickly can I get back to normal, and is it worth the money. The answers depend on your eye, your lifestyle and your alternatives — and we will go through all three together.

Next steps

If you would like to discuss femtosecond laser LASIK in person, we run consultations across 17 UK clinics and offer a full diagnostic workup as part of the initial visit. You can book at any of our locations, or send an enquiry through the contact page.