The femtosecond laser is an infrared laser (wavelength: 1,053 nm) with ultra-short pulse duration (10–15 s). Contents • LASER history • Wave theory • Overview of LASER • Application of LASERs in Ophthalmology • LASER Safety • 1917 - A. Einstein: Laser possible. As the corneal incision is well shaped, it can be converted to full-thickness keratoplasty in case of Descemet membrane perforation. Both excimer and femtosecond laser technology will serve for better human health as long as we apply it appropriately. Contact our London head office or media team here. Epipolis laser in situ keratomileusis (Epi-LASIK) was first reported by the Greek doctor Pallikaris in 2003. Login to your personal dashboard for more detailed statistics on your publications. B, Correction of hyperopia by steepening the central corneal optical zone and blending the periphery. 1st commercial excimer laser in ophthalmology by ZEISS >20yr First topography-guided customized treatments from ZEISS 1.3s Outstanding ablation speed with MEL 90 of up to 1.3s/D Explore the ZEISS excimer laser portfolio ZEISS MEL 90 excimer laser The MEL ® 90 from ZEISS is one of the most advanced excimer laser systems available today. In astigmatism correction, static cyclorotation component and dynamic cyclorotation component techniques greatly improve the effectiveness. Though femtosecond lasers reduce the incidence of complications such as buttonhole perforation, incomplete flap, free cap, and irregular cuts, there are still some specific limitations in FS-LASIK. Department of Ophthalmology and Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA . In addition, it saves the cost of the microkeratome or femtosecond laser used in LASIK. Thermal damage to neighboring tissue in the cornea has been measured to be in the order of 1 μm. Therefore, Epi-LASIK avoids direct stimulation of alcohol and reserves the intact epithelial basement membrane, which results in good subjective feelings in patients as well as quick recovery and haze reduction. Presbyopia is an age-related condition in which accommodation gradually decreases and the eyes are unable to focus and obtain clear near vision. The subjective part includes vision acuity (near, intermediate, and distance) and contrast sensitivity, whereas the objective part includes the objective wavefront aberration, point spread function, modulation transfer function, visual quality scale, and so on. However, whether the femtosecond laser has an effect on endothelial cell loss and visual acuity after donor tissue preparation has yet to be determined [18, 30]. What is excimer laser surgery? It has become the focus in the refractive surgery field recently and the first choice to treat ametropia with or without an irregular cornea. Excimer laser or Exciplex laser is a type of laser that uses ultraviolet light to produce microelectronic devices, eye surgery laser, semiconductor integrated circuits, and micro-machines. The gas mixture in a typical excimer laser consists of 2–9% of a noble gas, 0.2% of a halogen gas, and 90–98% of a buffer gas which serves as a medium to transport energy. _____ Table 3 The Excimer Laser. It can also create thinner flaps with minimum effects on stromal architecture. A small capsulorhexis has been associated with anterior capsule fibrosis. Home > Proceedings > Volume 0894 > Article Translator Disclaimer On the contrary, in peripheral PresbyLASIK, the central area is shaped for distant vision and the mid-peripheral corneal area for near vision. O'Brart [3] also thought PRK showed better cornea curvature and excellent visual quality compared with those of lamellar corneal refractive surgery. Patients need to be shifted under the operating microscope after application of laser treatment. It can remove approximately 1/2,000th of the corneal thickness per laser pulse and the spot size can be adjusted from less than 1mm to almost the entire corneal diameter. Some pattern of incisions that are not compassable with conventional technique can be achieved by femtosecond laser. Lasers in Ophthalmology LASER is an acronym. It removes the diseased endothelium and leaves the posterior cornea intact. Carbon dioxide (CO2): 10600 (photoThermal) Holmium YAG: 2100 (photoDisruption) Nd:YAG: 1064 (photoDisruption) Pulsed dye laser: 585-600 (photoChemical) aRgon green: 514 (photoChemical) Excimer: 193 (photoAblation) Indications of Laser… eye and damaging the retina. Complications. The wavelength of excimer laser depends on the composition of the active medium ( i.e noble gas + halides). The femtosecond laser offers a precise and predictable means to create the uniform thickness of the posterior stromal rim and control big bubble expansion that cannot be achieved by manual operation. Femtosecond Laser (FSL) radiation however is emitted in the near-infrared wavelength and it is unclear whether HSK activation after FSL is related to the laser wavelength. The advantages of ALK over PKP include being less invasive and having a decreased rate of rejection. Laser-tissue interactions, including histological and molecular studies, associated with the solid state laser wavelengths (210-213nm) and the excimer laser wavelength (193nm) are compared and contrasted. Ophthalmology Equipment Guide; Laser - Excimer Models; X. Ophthalmology Resource Guide. 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. Nevertheless, the focal energy output is high. IntraCor surgery is promising in the field of presbyopia correction [18]. ... Pulsed – energy delivered in briefbursts, more power Examples: Nd YAG, Excimer lasers Continuous – Argon, krypton lasers, diodelasers, and dye lasers 10. Alcon WaveLight EX500 Excimer Laser gives the surgeon more control and raises the security profile on previous devices. Therefore, the technique evolved into SMILE. In addition, as a cold laser, the excimer laser can ablate the tissue accurately without thermal damage. Descemet’s membrane endothelial keratoplasty (DMEK) has been proven to result in faster visual recovery, fewer higher order aberrations, and lower rejection rates by abundant evidence. Epstein and Gurgos [15] reported that 89% hyperopia (25/28) patients and 91.3% myopia (94/103) patients who underwent peripheral PresbyLASIK were completely spectacle independent and with distance unaided visual acuity of 20/20 in 67.9% (19/28) in hyperopia patients and 70.7% (53/75) in myopia patients. Dies ermöglicht ihren Einsatz als hochpräzise Werkzeuge in der refraktiven Chirurgie zur Korrektur von Refraktionsfehlern des menschlichen Auges. Uses — therapeutic. The femtosecond laser can be programmed to create corneal channels at a specific depth and orientation with high predictability and precision to allow safer insertion of Intacs segments. We use cookies to help provide and enhance our service and tailor content and ads. More consistency in the architecture is also achieved, which leads to better incision sealing without stromal hydration at the end of the surgery. News. An increased rate of diffuse lamellar keratitis, a sterile inflammatory reaction, was also observed in FS-LASIK because of the higher flap interface inflammatory response to laser energy and gas bubbles. ExciStar excimer lasers are tabletop-size lasers designed for easy system integration. The term “excimer” is an abbreviation of the expression excited dimer, and denotes a molecule RH* in the excited state, E 1, which does not exist in the ground state, E 0 (Fig. More than 20 years of experience, state-of-the-art technology and top experts. Therefore, LASEK can be considered a kind of PRK that is “wearing flap.” The key to success throughout the surgical procedure is the activity and good adhesion of the flap. A precise size and centration capsulorhexis are essential to optimize the IOL position. Hence, it has been considered as the representative operation of the laser corneal surface refractive surgery, and it is a step closer to the perfect refractive surgery. Because of the response of corneal keratocytes to the energy and inflammatory responses of adjacent tissues to gas bubbles, patients may encounter photophobia, called transient light-sensitivity syndrome (TLSS), early after FS-LASIK. Although the femtosecond laser showed excellent advantages over manual operation in cataract surgery, there are still some inevitable limitations and complications. Second, it has less effect on the corneal nerve and less serious dry eye syndrome than LASIK. It changes the topographic and refractive characteristics of the central portion of the cornea selectively with femtosecond laser. The femtosecond laser can also be applied in case of high degrees of post-keratoplasty astigmatism. Flap formation is critical to a successful LASIK surgery. It was applied in the steps of corneal incision, arcuate corneal incisions, capsulorhexis, lens fragmentation, and liquefaction. 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