2. Background
Femtosecond (FS) laser is an infrared
laser with a wavelength of 1053nm.
Works by producing photodisruption
or photoionization of the optically
transparent tissue such as the
cornea.
FS laser has pulse duration in the
femtosecond range (10-15 second)
3. Background
Femtosecond laser differs significantly from Yag
Laser in the amount of collateral damage they
cause. Nd:YAG laser has a pulse duration in the
nanosecond range (10-9 second) where as FS laser
has pulse duration in the femtosecond range
(10-15 second).
4.
5.
6. Femtosecond laser in ophthalmology
Uses:
•Femtolasik
•Femtosecond cataract surgery
•Femtokeratoplasty
•Femtosecond laser in
keratoconus
13. Advantages:
Optimal safety
No flap related complications e.g.: free cap, button
holes, incomplete cuts
- Thinner flap:
Uniform thin flaps with no liability of complications
Thin flaps leads to large stromal bed with less liability
for ectasia
- Precise depth
15. Advantages:
Flap Design
Large flap diameter : in HMT, in custom
ablation
Hinge : superior or nasal if there is cylinder
Hinge angle can be also modified
18. Flap edge
Flap edge :
Femtosecond laser can create
a corneal flap that has edges
that enable the flap to fit
more securely in place,
(inverted Side cut) > 90
degree “ beveled edge”
Better Biomechanics
M2 flap : 40: 70 degree
21. Complications that can occur with a
femtosecond laser as well as a
microkeratome
Flap striae (wrinkles in the flap)
Diffuse lamellar keratitis, DLK (inflammation
under the flap)
Epithelial ingrowth
22. Complications related to Femtolasik only
Opaque bubble layer:
Gas bubbles in the
intralamellar space, above
and below the resection
plane.
Early OBL tends to spread
ahead of the raster pattern
23. Transient light sensitivity syndrome (TLSS):
•Patients can present with
moderate to extreme light
sensitivity.
•Caused by keratocyte
activation or gas migration
to the corneal periphery
•Transient phenomenon
39. • Femtolasik is a relatively new procedure with
many advantages.
• Most important advantages include optimal
safety, with less complications, flap design
ability and less effect in the posterior segment.
• Our most Femtolasik problem is that it is an
expensive technique so we preserve it for
indicated cases.