First Clinical Results With the Femtosecond Neodynium-glass Laser in Refractive Surgery

Abstract

PURPOSE: We evaluated four femtosecond laser intrastromal cutting procedures: creation of a corneal flap for laser in situ keratomileusis (LASIK), tunnel and entry cut for intracorneal ring, corneal flap and removable lens for keratomileusis, and intrastromal ablation for myopia and hyperopia. METHODS: A clinical trial using a femtosecond surgical laser (IntraLase Corporation) was performed in partially sighted eyes. Femto-LASIK treatment was performed on 46 eyes up to -14.00 D; 16 patients received intracorneal ring segments (Femto-ICRS); 5 patients each with one highly myopic eye had femtosecond laser keratomileusis (FLK), and 13 patients each with one myopic or hyperopic eye had intrastromal ablation (ISPRK). In Femto-LASIK, excimer laser ablation was done under the flap. In Femto-ICRS, ring segments were introduced into the laser-created channels. In femtosecond laser keratomileusis, a lens-shaped block of stroma was removed manually from under the flap. RESULTS: No difference was found between the results obtained with Femto-LASIK and a standard microkeratome. No refractive effects occurred when the created flap was not elevated. In cases of Femto-ICRS and conventional ICRS produced the same refractive results. With Femto-ICRS, no intraoperative complications occurred and visual acuity improved immediately after surgery. In femtosecond laser keratomileusis, high myopia was corrected without using excimer laser ablation; centralization of the treatment area was excellent. In intrastromal ablation, 1 to 2 hours after surgery the corneas were highly transparent; refractive results were stable. CONCLUSIONS: Femtosecond lasers can produce precise intrastromal cutting, offering significant safety and other advantages (no razor blades, corneal trauma, partial resections, or sterilization issues) over current techniques. [J Refract Surg 2003;19:94-103]

Survival analysis of myopic regression after small incision lenticule extraction and femtosecond laser-assisted laser in situ keratomileusis for low to moderate myopia

“…In 2003, Ratkay-Traub et al [1] reported that femtosecond laser-assisted laser in situ keratomileuses (FS-LASIK) had many advantages over mechanical microkeratome, including fewer free caps, buttonholes, and irregular flaps. The disadvantages of FS-LASIK, by contrast, included its relatively complicated procedures involving the femtosecond laser used to make the flap Open Access *Correspondence: zhangfj126@126.com and the excimer laser used to perform corneal reshaping.…”

Avaliação do conhecimento sobre cirurgia refrativa por meio de questionário eletrônico

“…A CVL vem ganhando destaque ao longo das últimas décadas, devido principalmente ao potencial de resultados melhores, com o advento do excimer laser, (19) do laser de femtossegundo (20) e da avaliação da biomecânica corneana por meio de novos aparelhos (21)(22)(23) . Ainda assim, considerar que há garantia total dos resultados com o uso de aparelhos modernos pode ser considerado uma conclusão perigosa, tanto para os pacientes, quanto, particularmente, para os oftalmologistas.…”

X-ray emission during the ablative processing of biological materials by ultrashort laser pulses

“…Subsequently, the flap is repositioned, covering the laser-treated surface. In the further development of the LASIK technique, the initial cutting of the flap by mechanical blades was substituted with an usp laser process, taking benefit of this fully contactless and sterile flap-cutting method [29,30]. At laser intensities of ≈ 10 11 W/cm 2 the optical breakdown in the corneal tissue is used to generate pronounced cavities on the micrometer scale.…”