Types of LASIK Surgery Explained: Bladeless, Contoura, InnovEyes, SMILE and Zero-Touch.

Choosing laser eye surgery in Pune, or anywhere in India, today means choosing from a menu of names: Bladeless LASIK, Contoura Vision, InnovEyes, SMILE, Zero-Touch. Each comes with a different price, and each is described as the most advanced. As a cornea and refractive surgeon, I want to explain in plain language what these types of LASIK surgery actually are, what the research shows, and how to decide which one, if any, suits your eyes.

The short answer.

Most of these names are either a different way of making the same correction or a brand name for a specific machine. For most people with an ordinary prescription and healthy eyes, all of them give very similar vision in the end. The thing that matters most is not the name on the package. It is whether your eyes have been properly tested, and whether the procedure suits your cornea, your prescription and your lifestyle.

What you hear at the clinic.

Each of these lines has some truth in it. Each also leaves out something important. And very often, each one comes with a higher price tag. Let’s go through them one by one.

First, how laser vision correction works.

Every laser vision procedure does the same basic job: it reshapes the cornea, the clear front window of the eye, so that light focuses properly on the retina. The differences are about how the surgeon gets to the layer that needs reshaping, and how the laser pattern is planned.

There are three ways to reach the corneal tissue:

1. Make a flap, lift it, laser underneath, put the flap back. This is LASIK.
2. Remove the thin surface skin (epithelium) and laser the surface. This is PRK or surface ablation.
3. Cut a small lens-shaped piece of tissue inside the cornea and pull it out through a small opening. This is SMILE and similar procedures.

Keep these three in mind. Every marketing name fits into one of them.

“Bladeless LASIK” (Femto-LASIK).

What it is

LASIK where the flap is made with a femtosecond laser instead of a fine blade called a microkeratome. The reshaping is still done with the same excimer laser afterwards.

What’s true

Laser-made flaps are more predictable in thickness and shape, and some flap-related problems are less common.

What’s left out

A Cochrane review of 11 trials (about 1,700 eyes) found the final vision is broadly similar with either method.¹ Bladeless LASIK still makes a flap, so it is still a flap procedure. It has its own trade-offs: in that review, inflammation under the flap (diffuse lamellar keratitis) was more common with the laser, while dry eye was more common with the blade. Laser flaps can also cause temporary light sensitivity. And the blade is no longer the scary thing many people imagine. In experienced hands, modern microkeratomes are safe.

Does it matter for you?

It is a reasonable choice and the standard in many clinics. But “bladeless” doesn’t mean “no flap” or “no risk”.

“Contoura Vision” (topography-guided LASIK).

What it is

A brand name for topography-guided treatment on a particular laser platform. The laser pattern is planned using a detailed map of the surface shape of your cornea, not just your glasses prescription.

What’s true

If your cornea has irregularities, the treatment can correct some of them as well as your prescription. In the US trial used for its approval in 2013, about 93% of eyes saw 6/6 (20/20) or better without glasses at three months, about 3 in 10 eyes could read at least one line further down the chart with glasses than they could before surgery, and glare and night-driving complaints went down on average.²

What’s left out

Many people have fairly regular corneas. For them, the advantage over a well-done standard (wavefront-optimised) treatment is usually small, and studies comparing the two disagree on how big it is. “Better than 6/6” is possible with several techniques. It is not a promise from any of them. Contoura is still LASIK, so it still has a flap.

Does it matter for you?

It can help if your corneal map shows irregularity. Ask to see your topography and ask, “What specifically will this correct in my eye that a standard treatment won’t?”

“InnovEyes” (ray-tracing guided LASIK).

What it is

InnovEyes is a newer, premium-priced LASIK treatment, usually sold as the step above Contoura. A diagnostic device (Sightmap) measures your cornea, how light passes through your whole eye (wavefront) and the length of your eye. Software then builds a model of your eye and uses ray tracing to plan the laser pattern. It is still LASIK, with a flap.

What’s true

In theory, it accounts for more of the eye’s optics than a plan based only on the cornea or only on your glasses prescription. Published results are very good. In one 400-eye study, every eye saw 6/6 (20/20) or better without glasses at three months.³

What’s left out

This is the part patients are rarely told.

• Not every eye qualifies. The treatment depends on the machine’s measurement agreeing with your actual prescription, the one found when you read the letter chart. In the 400-eye study, the plan was used only when the machine’s reading and the chart prescription agreed within 0.5 dioptres. The paper does not say how many people were screened and turned away because their readings did not match. Excellent results among the eyes that qualified do not tell you how often eyes qualify in the first place.
• Focusing effort skews the reading. Younger eyes in particular can focus involuntarily (accommodate) during the scan, and the amount varies from moment to moment. That can make you look more short-sighted than you are. Even surgeons who use InnovEyes recommend repeating the scan after drops that relax focusing in younger patients, and say that when the machine and the chart disagree a lot, topography-guided treatment (Contoura) is probably the better choice.⁴
• The evidence is still early. Many published results stop at three months, most studies are single-centre or have no comparison group, and several authors are consultants to the manufacturer. There is no head-to-head randomised trial yet. A 2025 analysis set the two US approval trials side by side: topography-guided LASIK (the technology behind Contoura) gave far more eyes exceptionally sharp vision, 6/3 (20/10) or better (about 16% vs 3%), while ray tracing gave a bigger gain in contrast sensitivity under glare.⁵ Neither is clearly the winner.

Does it matter for you?

It may help some eyes, but it is not automatically better than Contoura or standard LASIK. If it is offered, ask: “Did my Sightmap reading match my chart prescription? Was it repeated with drops? If it hadn’t matched, what would you have offered me instead?” If the answer is that you would have been offered Contoura anyway, ask what the extra cost is really buying.

“SMILE” (Small Incision Lenticule Extraction).

What it is

A femtosecond laser creates a thin, lens-shaped disc of tissue (a lenticule) inside the cornea. The surgeon then removes it through a small opening of a few millimetres. No flap is made. There are now similar procedures from other manufacturers under other names.

What’s true

There is no flap, so there are no flap complications such as a flap shifting after an injury. A meta-analysis of 12 studies found less dry eye and better corneal sensation after SMILE than after bladeless LASIK, with similar vision, though the quality of that evidence was low.⁶

What’s left out

• It is mainly for short-sightedness (myopia) with or without astigmatism. Options for long-sightedness are newer and not available everywhere.
• Vision may be a little blurrier in the first few days than after LASIK.
• If you need a touch-up, it is usually more complicated than after LASIK.
• “Most advanced” does not mean “best for every eye”.

Does it matter for you?

It is a good option for many people with myopia, and especially worth considering if you play contact sports or already have mild dry eye. It is not automatically better than LASIK.

“Zero-Touch” / “No-Touch” (transepithelial PRK).

What it is

Usually a form of surface treatment (PRK) in which the laser removes the surface skin and reshapes the cornea in one step. No blade, no flap and no instrument touches the cornea. A clip still holds your eyelids open.

What’s true

There is no flap, and more corneal tissue is left untouched. That makes it useful for thinner corneas, for people in contact sports or the armed forces, and for some people who are not suitable for LASIK.

What’s left out

Because the surface skin has to grow back, recovery is slower and more uncomfortable than LASIK or SMILE. Expect a few days of pain, watering and light sensitivity, with a bandage contact lens. Vision keeps improving over several weeks. One randomised trial even found more first-day pain with the no-touch method than with conventional PRK, with similar final vision.⁷ “Zero-touch” describes how it’s done. It does not mean painless or instant.

Does it matter for you?

It is a genuinely good option for the right eye. Just go in knowing what the first week will feel like.

At a glance.

Swipe sideways to see every column

Name you hear	What it actually is	Flap?	Recovery	Best suited for
Standard / Blade LASIK	Microkeratome flap + excimer laser	Yes	Fast (1–2 days)	Healthy, adequately thick corneas
Bladeless / Femto-LASIK	Laser-made flap + excimer laser	Yes	Fast (1–2 days)	Same as above
Contoura	Topography-guided LASIK	Yes	Fast (1–2 days)	Corneas with measurable irregularity
InnovEyes	Ray-tracing guided LASIK	Yes	Fast (1–2 days)	Eyes whose scan reliably matches their actual prescription
SMILE	Lenticule removed through a small cut	No	Fast, slightly slower first days	Myopia ± astigmatism, active lifestyles
Zero-Touch / TransPRK	Surface laser treatment	No	Slower (about a week, settling over weeks)	Thinner corneas, contact sports

What matters more than the name.

1. Proper screening. This means corneal thickness, corneal topography or tomography to rule out early keratoconus, tear film and dry eye testing, and a stable prescription for at least a year. A good clinic will sometimes tell you not to have laser surgery.
2. Your eye, not the menu. The right procedure depends on your prescription, corneal shape and thickness, your age, your job and your sports.
3. The surgeon’s experience with the specific procedure.
4. Honest expectations. None of these procedures prevent the need for reading glasses after about age 40 to 45. That comes from presbyopia, which is a different process.
5. Other options. If laser isn’t safe for your eyes, an implantable lens (ICL) may be, so don’t let anyone push laser at any cost.

Questions to ask your eye doctor.

• Which procedure do you recommend for my eyes, and why not the others?
• Can I see my corneal thickness and topography results?
• Is there anything in my scans that makes laser surgery riskier for me?
• What vision can I realistically expect, and what is the chance I need a touch-up?
• If I choose the more expensive option, what exactly will it do better for me?
• What happens if I have a complication, and is follow-up care included in the price?

Frequently asked questions.

The bottom line.

Bladeless, Contoura, InnovEyes, SMILE and Zero-Touch are all legitimate, well-studied techniques. None of them is a scam, and none of them is magic. For most people, a properly screened eye treated by an experienced surgeon will do well with more than one of these options. Be cautious when a name is used to justify a much higher price without a clear reason that applies to your eye.

Have questions about which procedure suits your eyes? A thorough evaluation, including corneal thickness, topography and dry eye testing, is the right first step. You can book a consultation at EYON Eye and Laser Institute, Kharadi, Pune.

References.

1. Kahuam-López N, et al. LASIK with a mechanical microkeratome compared to LASIK with a femtosecond laser for adults with myopia or myopic astigmatism. Cochrane Database Syst Rev 2020;CD012946. Link
2. Alcon WaveLight ALLEGRETTO WAVE Eye-Q approved by US FDA for topography-guided LASIK (Nov 2013), with phase III trial results. Link
3. He G, Bala C. Ray-tracing guided myopic LASIK: real-world clinical outcomes. J Cataract Refract Surg 2023;49:1140–1146. Link
4. What does ray tracing-guided LASIK have in store? Review of Ophthalmology, February 2026. Link
5. Sitto MM, Moshirfar M, et al. Comparison of US FDA premarket approval studies between ray tracing-guided LASIK with InnovEyes Sightmap versus topography-guided LASIK. Ophthalmol Ther 2025;14(12):2983–3005. Link
6. Shen Z, et al. SMILE versus FS-LASIK for myopia: a systematic review and meta-analysis. PLoS ONE 2016;11(7). Link
7. Comparison of transepithelial and conventional PRK in myopia and myopic astigmatism: a randomized contralateral trial. BMC Ophthalmology 2022. Link
8. American Academy of Ophthalmology. Refractive Surgery Preferred Practice Pattern. Link

This article is for general information only and is not medical advice. Your eyes need a full examination by a qualified eye specialist before any decision about surgery.

Dr. Bhalekar performs refractive surgery at EYON Eye and Laser Institute and has no financial ties to any laser manufacturer.

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