Breakthrough idea in LASIK surgery

Things may be looking up for the estimated a million people eligible for vision correction surgery. New technology is making LASIK safer and better.

LASIK is the nation’s most popular vision correction procedure, representing approximately 90 percent of all refractive procedures performed annually. In 2012, some 1.4 million LASIK procedures were performed.

The surgery has always been a two-step process. In the first step, the surgeon makes a thin flap and folds it back for the second step, during which a device called an excimer laser is used to ablate corneal tissue for vision correction.

Until now, advancements such as Custom LASIK and Wavefront have focused on improving the second step (precise tissue ablation). Now, new research shows the importance of the first step on visual outcomes. The discovery was made when surgeons began using a new laser, instead of the handheld microkeratome blade, to create the corneal flap.

Doctors found that in addition to fewer complications, more patients achieved vision better than 20/20—up to 20/15 and even 20/12.5 when the Femto laser was used in the first step.

Eighty-eight percent of patients have better than 20/20 vision—up to 20/15— after having FemtoLASIK, the ultra-fast, ultra-safe laser replaces the metal blade used in traditional LASIK.

“Data now validates what we suspected but hadn’t proven; that the rate of achieving high levels of vision is better with the Femto laser than with the metal microkeratome,” says Dr. Somchai T.

For many people eligible for LASIK

who have held off on having the procedure due to the fear of the blade and/or complications, here are some great reasons to consider having it now:

• Better Vision: More patients achieve statistically better vision with Femto LASIK—often better than 20/20.
• Improved Safety: Femto LASIK virtually eliminates the most severe complications.
• Fewer Retreatments: The number of LASIK retreatments required to perfect the visual outcome is significantly lower.
• Reduced Dry Eye Symptoms: Clinical studies of dry eye symptoms showed a reduction by as much as 72 %.
• Benefits More Patients: Patients with thin corneas who may not have been considered for the LASIK procedure, may now be candidates. If you’ve been holding off on having your vision corrected and are ready to take the plunge, ask your ophthalmologist to use Femto laser instead of a blade, the safest option now available for LASIK.

We are committed to providing the best quality treatments to our patients by using the world’s leading refractive technologies. Therefore, we started performing femto-LASIK with the FEMTO LDV femtosecond laser (Ziemer Group). In this time, we have come to realize that the FEMTO LDV is the ideal technology for refractive surgeons who desire to complete their LASIK procedures with a high level of safety and patient satisfaction.

The clinical outcomes, surgical quality, and usability of the first and second FEMTO LDV systems were excellent, and we recently worked together with Ziemer to further improve the laser system in several areas. Ziemer has now developed these systems and released its new FEMTO LDV with remarkable features that fulfilled our expectations. The Z model is new to the market. We have started using this FEMTO LDV for corneal surgery in our clinic.

ADVANTAGES OF THE FEMTO LDV

Upon review of our experiences with the FEMTO LDV compared with other femtosecond lasers, we found that this laser excels in LASIK flap creation. The FEMTO LDV offer surgeons and patients many advantages:

High-speed, low-energy scanning system. The FEMTO LDV has a high-speed scanning system that generates low-energy laser pulses at the nanoJoule (nJ) level with high-pulse frequencies exceeding 5 MHz. According to an analysis of the effects of different energy levels on corneal stromal cells, greater inflammatory cell infiltration was observed in the cornea when using lasers with higher energy levels. These higher energy levels also triggered increased cell death. Additionally, typical complications caused by some femtosecond lasers, such as vertical gas breakthrough, rainbow glare, transient light sensitivity syndrome (TLS), opaque bubble layer (OBL) formation, and inflammation, were induced by higher pulse energy femtosecond lasers.

Tissue preservation. During flap creation with the FEMTO LDV, small and tightly overlapped dissection spots are produced, resulting in complete resection with no tissue bridges and a smooth stromal bed. It also produces significantly fewer gas bubbles and is free of edema. Besides tissue preservation, the handheld scanning device affords the surgeon a direct view of the cornea and ensures a highly precise cutting depth.

Ergonomic design. Laser energy is deployed from a handpiece that is attached to a maneuverable articulated arm, meaning patients can be treated on the excimer laser bed instead of relocating between the flap creation and ablation procedures. Using the FEMTO LDV, both surgeon and patient can stay in a single position. Therefore, the entire bilateral LASIK procedure can be completed within 6 minutes.

Short procedure time. As the scanning system improved the speed of the operation, the cutting time using FEMTO LDV is now less than 15 seconds. Patients are more comfortable and feel less stress during the procedure