Femto-LASIK (Laser LASIK) and Femtosecond Laser
Who developed the femtosecond laser technology?
Why is the femtosecond laser just now being used in Germany/Europe?
Can the femtosecond laser be used in any other surgical
procedures?
Will Femto-LASIK (Laser LASIK) replace PRK / LASEK in the future?
How often do surgical complications occur?
Can the infrared laser energy of the femtosecond laser damage
the eye?
What about increased sensitivity to glare after surgery?
Is manual lifting of the corneal flaps in Re-LASIK dangerous?
Who developed the femtosecond laser technology?
That is a difficult question. Even before discovering Excimer (cool laser)
laser technology, which made laser eye surgery possible, researchers had
been trying to correct visual disorders by changing the shape of eye.
In the early 1990’s Bille, Swinger and Liu published the first
papers concerning intrastromal ablations (surgical removal of eye tissue)
with the Pico-Second laser. Unfortunately, the laser pulse was too slow
to make a clean incision in the targeted area of the eye without damaging
surrounding tissue. At the end of the 1990’s Femto Second laser
technology was developed (1fs = one quadrillionth of a second). No undesired
tissue damage occurs here, but the application of generating a reliable
laser pulse at such high speeds became even more complex.
Dr. Holger Lubatschowski of the Laser Center in Hannover contributed
a large part in developing the femtosecond laser technology that is used
today. Unfortunately, he published his findings before they were patented.
His laser microtome was integrated into various laser devices and was
researched and tested mainly in the US.
The use of the femtosecond laser in ophthalmology was developed by a
team of physicists, biomedical engineers and ophthalmologists at the University
of Michigan, Center for Ultrafast Optical Sciences.
Why is the femtosecond laser just now being used in Germany/Europe?
German research centers have almost no financial backing. That is why
the latest technology, such as femtosecond lasers, is usually developed
and used in the USA. Besides that, refractive surgery in Europe is not
nearly as popular as it is in the USA. By 2001, over 200,000 successful
Femto-LASIK surgeries had been performed in the USA.
In June 2004, Dr. Stephen Glenn Slade (the "King of LASIK Surgery")
performed the first Femto-LASIK in Germany at the ALZ Eye Laser Center in Munich.
Our patients enjoy the benefits of having access to a reliable technology
applied to surgical procedures that have been already been perfected.
Can the femtosecond laser be used in any other surgical procedures?
Yes. Femtosecond laser technology has opened application areas in cellular
biology, dental surgery and in surgery of the inner ear. But, laser eye
surgery has assumed the leadership role in developing this technology.
We anticipate the use of femtosecond lasers to expanded opportunities
in corneal transplants. The laser is especially suited to prepare the
corneal pockets for that procedure.
Will Femto-LASIK replace PRK / LASEK in the future?
Clinics that do not have a femtosecond laser will no doubt continue to
treat patients with thin corneas with the PRK / LASEK. Nevertheless, the
healing process is more painful and usually takes longer than with LASIK.
In our clinic, PRK/LASEK is only used for therapeutic purposes such as
treatment of recurring cornea erosions or removal of cornea surface scars.
How often do surgical complications occur?
Since 1993 we have performed 20,000 LASIK procedures and have seen 23
serious complications (0.1%). From 1998 -1999 five procedures resulted
in surgical errors known as “buttonhole” cuts (0.025%). An
investigation determined the problem to be adherence to incorrect specifications
by the microkeratome (blade) manufacturer. In cooperation with the manufacturer,
the specifications were corrected and we changed our procedure accordingly.
Since then, not a single “buttonhole” has occurred in our
clinic.
Besides, flap-related complications were eliminating with the use of the
femtosecond laser
Can the infrared laser energy of the femtosecond laser damage
the eye?
Due to the ultra-short treatment time of the femtosecond laser –
somewhere in the range of 500-750 billionth (10-15) seconds, very little
energy is required to achieve photo disruption (the “cutting”
action of the laser). The exposure period is so short, and the laser so
precise that any tissue beyond several micrometers of the treatment area
is completely unaffected.
What about increased sensitivity to glare after surgery?
Glare sensitivity depends on the width of the pupil in the dark. Patients
with large pupils can experience an increased degree of sensitivity. However,
the size of the pupil can be calculated during a careful pre-examination.
If the pupil is out of range in the dark, we do not recommend laser eye
surgery. With most Femto-ASIK procedures, sensitivity to glare is only
temporary and varies with the individual patient’s healing time.
Is manual lifting of the corneal flaps in Re-LASIK dangerous?
The instruments used to lift the corneal flaps during this procedure are
designed in such a way that they cannot injure the cornea. The flap will
be more stabile than ever due to equalized thickness from the initial
LASIK. Besides that, our surgeons are experts in manual precision surgery.
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