What is Femto Second Bladeless LASIK?

Any LASIK procedure basically has two main steps, first is to create a very thin CORNEAL FLAP (can be created either by blade-microkeratome or bladeless-femtosecond laser) and then treat-ablate the remaining corneal bed by EXCIMER Laser to reshape the cornea in order to nullify spectacles power.

Hence it is only the first step of creating flap which is different in blade and bladeless Lasik…the rest procedure of glasses correction by Excimer Laser is same in both.

FEMTO Laser : A Femtosecond is one millionth of a nanosecond or 10 -15 of a second and is a measurement used in laser technology. The femtosecond laser is used to create flap of cornea with varied specifications, which gives the surgeon more control, precision and increases the SAFETY FACTOR:

  • Flap Shape – Planar (better then microkeratome flap)
  • Good Visual Procedure Control
  • Customised: Flap Thickness & Diameter Control By Computer
  • Cut Pattern - Raster/Spiral-happens under direct visualization
  • Side cut angle – can be customized to 90 –prevents epithelial ingrowth, decreases chances of epithelial folds, allows snug fit of flap on cornea bed.
  • The suction ring creates an intraocular pressure (IOP) of approximately 40 mm Hg which is lower then created by microkeratome -60mmHg, hence safer for patients with ocular hypertension or borderline well controlled glaucoma patients.
  • The uniform thickness and vertical cleavage plane fits the flap like a manhole cover on stromal bed, minimizing the chance of flap slippage or wrinkling if accidentally rubbed or bumped during healing after surgery.
  • If the surgeon encounters a loss of vacuum during flap creation with the femto laser, the flap creation can be repeated immediately with no known adverse affect.
  • Because the femto laser software enables the laser to produce flaps with vertical edges, it is more difficult for epithelial cells to migrate down under the flap into the interface since the length of the route for those cells is increased.

Advantages:

  1. Reduced incidence of flap complications like buttonholes, free caps, irregular cuts etc.
  2. Greater surgeon choice , customization and control over flap diameter and thickness, side cut angle, hinge position and length
  3. Increased precision with improved flap safety and better thickness predictability
  4. Capability of cutting thinner flaps to accommodate thin corneas and high refractive errors
  5. Stronger flap adherence, decreased incidence of epithelial ingrowth under flap
  6. Less increase in IOP –so better for ocular hypertension & borderline glaucoma cases.
  7. Lesser incidence of dry eyes
  8. Loss of suction during FS laser LASIK flap creation is easier to handle and the suction ring may be reapplied and treatment resumed immediately in many cases

PATIENTS GAIN CONFIDENCE: The higher degree of comfort and safety, virtually almost no risk of complications, and more predictable outcomes increase patient satisfaction in their experience and outcome. Patient Comfort is good as surgical procedure is fast hence there is no trauma to the eye and patients tend to be very relaxed during the procedure.

However, the technique presents with its unique set of disadvantages and related complications: Opaque bubble layer (OBL) , Transient light sensitivity syndrome (TLSS), Lamellar keratitis , Femto laser flaps are slightly more difficult to lifT in case of retreatment required, increased cost due to added machine cost. Studies have shown FS laser to be safer while the visual and refractive outcomes of FS laser LASIK are equivalent to microkeratome LASIK. Your surgeon will guide you as to which procedure is better for you after examining your eyes.

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