The bed connecting the femto and the laser is the same, so the patient is automatically transferred on to the excimer laser. To compare postoperative evolution of visual acuity, flap thickness, and stromal optical density during the first 3 months after femtosecond fs laser in situ keratomileusis surgery for correction of myopia using the ifs 150khz fs laser and lensx fs laser platforms. However, the femtosecond laser has a potential advantage in predictability, although this finding was not significant. The visumax femtosecond laser is an ophthalmic surgical laser designed to create small cuts incisions in the transparent layer on the front of the eye the cornea. This spotlight discusses femtosecondlaser assisted lasik surgery and its three primary components. During this bladeless procedure, your surgeon uses the femtosecond laser to create a flap in your cornea before altering the shape of the underlying tissue to correct your.
Yag laser results in the generation of a rapidly expanding cloud of free electrons and ionized molecules. The femtosecond laser is a highenergy optics technology used for eye surgeries and other medical procedures, including all laser lasik. This spotlight discusses femtosecond laser assisted lasik surgery and its three primary components. Femtosecond laser flaps also tend to be more uniform in thickness from the center to the periphery than microkeratome flaps. Contact corneal applanation versus liquid immersion jonathan h. Lasik flaps were created using the 60khz intralase femtosecond laser abbott medical optics, inc. Relex is an allinone femtosecond laser refractive procedure, and in this study, results were comparable to fslasik. With either technique, lasik has been shown to be a successful procedure, with equivalent visual outcomes and low complication rates. Flap complications from femtosecond laserassisted in situ. Lasik laser assisted in situ keratomileusis keratomileusis is the procedure of opening the eye and altering the cornea. Product guide femtosecond laser instruments duckworth kent.
The action of the visumax and other femtosecond lasers mimics the cutting action of mechanical or bladebased keratomes. The flap is lifted and the lenticule is removed and discarded the flap is repositioned the removal of the lenticule reduces the curvature. Throughout the past five years, we have gained experience with several femtosecond lasers. The femtosecond laser is a highenergy optics technology used for eye surgeries and other medical procedures, including alllaser lasik. To establish safety and effectiveness of thinflap lasik using a femtosecond laser and microkeratome in correcting high myopia in chinese patients. The femtosecond laser is used to cut a small lensshaped segment of tissue lenticulewithin the center of the cornea made in the anterior cornea with the laser similar to the flap created in lasik. Nevertheless, lasek has some common risks of surface ablation in high myopia correction, such as postoperative haze and side effects of corticosteroid eye drops required after surgery. Safety and effectiveness of thinflap lasik using a. During this bladeless procedure, your surgeon uses the femtosecond laser to create a flap in your cornea before altering the shape of the underlying tissue to correct your vision. Comparison of visual and refractive outcomes following femtosecond laserassisted lasik with smile in. Femtosecond lasers belong to a class of ultrashort pulse lasers or ultrafast lasers. It thus also belongs to the category of ultrafast lasers or ultrashort pulse lasers which also include picosecond lasers.
This family of industrial femtosecond lasers is ideal for ultrafine processing of materials with little or no heat affected zone haz. Several advantages of the femtosecond laser over mechanical microkeratomes have been reported in lasik surgery. This groundbreaking laser system employs highperformance femtosecond laser technology and is characterized by its cutting precision, speed and gentle treatment technique. Femtosecond lasers that are used for lasik procedures are solidstate. Excimer laser and femtosecond laser in ophthalmology. The refractive surgery community continues to debate whether to use either a blade or laser to create corneal flaps. Wellinformed with respect to the benefits of technology and its contribution to the safety and efficacy of the lasik procedure, todays patients are. Optical patient interface in femtosecond laserassisted. Lasik laser refractive surgery lasik is a common procedure to treat nearsightedness, farsightedness and astigmatism. Femtosecond laser for myopia and hyperopia correction. Femtosecond lasers are a type of laser that discharges optical pulses in femtoseconds. Take courses on a variety of topics or complete clinical training certifications from wherever you are. Since then, the use of femtosecond lasers has expanded to other corneal surgeries and, more recently, to cataract surgery.
This laser first relieved us of our apprehensions while using microkertome in 2000s by making designer software corneal flaps for us in lasik and then went. Femtosecond laser femtosecond lasers the all laser lasik solution. A consecutive series of 129 patients 255 eyes who underwent fslasik for correcting myopia andor astigmatism using upgraded wavelight fs200 femtosecond laser with the. Complications related to femtosecond laserassisted lasik. Femtosecond laser systems have strict ambient humidity and temperature requirements for proper operation, but advances in fs laser technology are making the newer machines less sensitive to environmental perturbations. The manual aspect of the microkeratome is challenging. The zeiss visumax is thus the ideal platform for therapeutic and refractive laser applications such as lenticule extraction with smile from zeiss and femtolasik flap cuts. From expert surgeons and modern technology, to a variety of payments options and online scheduling, lasik plus is here to make 2020 vision accessible regardless of your age, prescription, or lifestyle.
A femtosecond laser is used to create a circular, hinged flap in the cornea, which allows the surgeon access to the tissue affecting the eyes shape. Target materials for these femtosecond laser products include glass, oled, ic packageswafers, and flexible thin films. Femtosecond laser is the new high tech precision knife. Femtosecond laser assisted flap creation in lasik surgery has rapidly become popular with increasing safety and efficacy over time 1,2,3,4. The use of femtosecond lasers has created an evolution in modern corneal and refractive surgery. Femtosecond lasers in ophthalmology touchophthalmology.
The ifs femtosecond laser is an ophthalmic surgical laser indicated for use in patients undergoing surgery or treatment requiring initial lamellar resection of the cornea, in treatment requiring initial lamellar resection of the cornea to create tunnels for placement of corneal ring segments, in treatment requiring arcuate cutsincisions in. Modelocking is a technique in optics by which a laser can be made to produce pulses of light of extremely short duration, on the order of picoseconds 10. Complications of subbowmans keratomileusis with a femtosecond laser in 3009 eyes. The surgeon then uses ultrasonic power to break up the natural lens and remove it from the eye. This article discusses the clinical advantages and disadvantages of the femtosecond laser and mechanical microkeratome for lasik flap creation. Femtosecondlaserassisted lasik eye surgery and imaging spie. We then became the first center in athens, greece and one of the first centers in europe to go exclusively to femtosecond lasik. When using femtosecond laser for flap creation, each pulse of the laser causes the generation of a small amount of microplasma at its focal point in the corneal tissue leading to formation of microscopic gas bubbles and cavitations, which then dissipate. More than 15 million patients have undergone the surgery, which has a low complication rate of approximately 1%. Femtosecond laser technology for alllaser lasik surgery. Intralase femtosecond laser vs mechanical microkeratomes in lasik for myopia.
Pdf femtosecond laser technology in corneal refractive. This is a pdf file of an unedited manuscript that has been accepted. The emergence of femtosecond laser technology has revolutionized lamellar flap creation. When used in conjunction with an additional standard femtosecond opa, it offers the potential to provide both femtosecond and picosecond tunable beams simultaneously.
Refractive predictability and corneal aberrations at 3 months seemed better than or equal to fs. Flap creation is a critical step in laser in situ keratomileusis lasik. Femtosecond laser femtosecond lasers the alllaser lasik solution. Femtosecond laser assisted cataract surgery traditionally, surgeons use blades and other cutting instruments to create the capsulotomy, an incision of the outer layer of the cataract, during cataract surgery.
Visumax combines excellent precision with bestinclass speed and treatment comfort in performing advanced femtosecond laser applications as flap, keratoplasty, incision for icr and relex the step towards minimally invasive laser vision correction. Rp photonics encyclopedia femtosecond lasers, ultrashort. The femtosecond laser was initially introduced for creation of corneal flaps for laser in situ keratomileusis lasik. The evolution of corneal and refractive surgery with the femtosecond laser the harvard community has made this article openly available. Femtosecond lasers for lasik flap creation ophthalmology. Laser in situ keratomileusis lasik surgery combines highablation precision and minimized collateral tissue effects to nonthermally dissociate dense corneal tissue.
Femtosecond laser technology has become a fixture in ophthalmology offices across the globe for good reason. In addition, it saves the cost of the microkeratome or femtosecond laser used in lasik. During the all laser lasik procedure, our experienced surgeons rely on femtosecond lasers to create a corneal flap. Your story matters citation aristeidou, antonis, elise v. Femtosecond laserassisted cataract surgery traditionally, surgeons use blades and other cutting instruments to create the capsulotomy, an incision of the outer layer of the cataract, during cataract surgery.
During the alllaser lasik procedure, our experienced surgeons rely on femtosecond lasers to create a. Some studies have indicated a higher frequency of dlk in femtosecond lasik cases compared to microkeratome 8,27,45 with an incidence of stage 1 or 2 dlk as high as 10. Benefits of femtosecond laser versus manual flaps in lasik. What is more, lasek is a complex surgical procedure that requires high. The femtosecond laser has been utilized experimentally in preparation of donor tissue for endothelial keratoplasty as well as in vivorabbit models. The femtosecond laser became available for lasik flap formation. Yag laser works by producing photodisruption or photoionization of the optically transparent tissue such as the cornea1. The bladeless lasik procedure uses a femtosecond laser to create a flap in the corneal tissue without the use of a blade, also known as microkeratome. Mar 17, 2008 femtosecond lasers are a type of laser that discharges optical pulses in femtoseconds. With lasik, patients can achieve 2020 vision or better. With accuracy, safety, and repeatability, eye surgeons can utilize the femtosecond laser in almost all anterior refractive procedures. Comparison of visual and refractive outcomes following.
Maximum exposure allows application of suction ring and microkeratome run. Femtosecond lasers, unlike mechanical microkeratomes, in my opinion, provide the lasik surgeon with the precision and speed needed to produce excellent outcomes. Partha biswas for incising this current topic so precisely on the cme series for us. Pdf femtosecond laser has been introduced in refractive surgery to create a thinhinged corneal flap without using any blade. Femtosecond lasers and laser assisted in situ keratomileusis. Here at global laser vision, we offer our patients alllaser, bladeless lasik. Fs lasers are also rapidly gaining popularity in many other fields of medicine, such as in dentistry and neurosurgery. This spotlight discusses femtosecondlaserassisted lasik surgery and its three primary. Talamo, md, philip gooding, ms, david angeley, ms, william w. Lasik flaps created with the ifs laser offer excellent quality and control low energy, tight spot spacing and line separation create a smooth stromal bed, allowing for easy lift, 2 minimal inflammation 3 and fast flap creation 2 inverted bevelin side cut may provide fewer dry eye signs and symptoms than with 30 side cut 4.
Femtosecond laser in refractive and cataract surgeries. Femtosecondlaserassisted lasik eye surgery and imaging. Taniguchi2,3, michael tsatsos4, rodrigo muller2, colm mcalinden5,6, roberto pineda2 and eleftherios i. Visumax femtosecond laser small incision lenticule extraction. Femtosecond laser assisted flap creation allows a more reliable and reproducible flap. Femtosecond laser in laser in situ keratomileusis ncbi. A microkeratome, or blade lasik, is a handheld instrument or tool that is comprised of a steel blade that moves back and forth across the cornea during laser eye surgery to create the cut that is. When the fs laser was first developed, it did not gain tremendous notoriety until researchers determined that it could be used to cut corneal flaps as part of laser in situ keratomileusis lasik as well as cutting tunnels for the implantation of intracorneal ring segments icrs for the treatment of keratoconus. Each pulse of a femtosecond laser lasts 600800 femtoseconds.
High incidence of rainbow glare after femtosecond laser. Visumax femtosecond laser the visumax femtosecond laser system figure 1 is a precision ophthalmic surgical laser designed for the creation of incisions in the cornea. To evaluate a new technique for penetrating keratoplasty pk with the use of a new software algorithm for a femtosecond laser that is designed to create penetrating cuts for pk in. Taniguchi, michael tsatsos, rodrigo muller, colm mcalinden, roberto pineda, and eleftherios i. Femtosecond laser allows the formation of an elliptical flap customized to. The advent of femtosecond laser in the field of corneal refractive surgery has revolutionized flap creation in lasik 6. Apr 18, 2015 femtosecond laser for myopia and hyperopia correction. Second, we discuss the characteristics of the femtosecond laser and its application in corneal refractive surgery e.
Excimer laser and femtosecond laser in ophthalmology intechopen. Femtosecond fs laser is an infrared laser with a wavelength of 1053nm. Optical patient interface in femtosecond laserassisted cataract surgery. The femtosecond laser is the all laser option for lasik, other older technology, like microkeratome, requires a blade to make the corneal flap. When used in conjunction with an additional standard femtosecond opa.
We started doing all our lasik cases on the fs60 in the fall of 2006. Femtosecond lasers are designed to make thinner lasik flaps, with a tighter range of thickness around the mean. Intralase was the first femtosecond laser approved by the. Other names for the alllaser lasik procedure include brands such as. To compare the incidence of rainbow glare rg after femtosecond laser assistedlasik fslasik using the upgraded fs200 femtosecond laser with different flap cut parameter settings. I feel that there are certain intrinsic surgical pearls that one attains through using a femtosecond laser, that i think would be interesting even for the experienced lasik surgeon using a microkeratome. Oct 10, 2015 the femtosecond laser is used to cut a small lensshaped segment of tissue lenticulewithin the center of the cornea made in the anterior cornea with the laser similar to the flap created in lasik. Lasik uses an excimer laser to perform the alterations and either a knife or a femtosecond laser to create the opening. The procedure has benefited millions of patients and sparked increased interest in the principles and research behind it. Lasik is an alternative to wearing glasses or contacts as it. Thin, uniform planar flaps result in minimal disruption of. Yag laser and the femtosecond laser have a similar wavelength, respectively 1,064 nm and 1,0301,060 nm, but the femtosecond laser provokes less damage in terms. Benefits and harms of femtosecond laser assisted cataract.
Mechanical microkeratomes and femtosecond lasers have been the two methods used for lasik flap creation. Efforts to improve the safety and predictability of the lamellar incision have fostered the development of femtosecond lasers. The visumax femtosecond laser is indicated for use in the smile procedure for the reduction or elimination of nearsightedness with or without astigmatism in patients who are 22 years of age or. The evolution of corneal and refractive surgery with the.
Paschalis2,3 abstract the use of femtosecond lasers has created an evolution in modern corneal and refractive surgery. Lasik has been the primary refractive surgical procedure for the past three decades. Visumax femtosecond laser small incision lenticule. Review open access the evolution of corneal and refractive surgery with the femtosecond laser antonis aristeidou1, elise v. A femtosecond laser is a laser which emits optical pulses with a duration well below 1 ps ultrashort pulses, i. Femtosecond laser technology in corneal refractive surgery. Thin, uniform planar flaps result in minimal disruption.