LOTUS EYE CARE HOSPITAL

LAUNCHED

BLADE FREE
INTRALASE LASIK/ ZYOPTIX TECHNOLOGY

FEMTOSECOND

(This definition follows U.S. usage in which a billion is a thousand million and a trillion is a 1 followed by 12 zeros.) A Femtosecond is one millionth of a nanosecond or 10 -15 of a second and is a measurement sometimes used in laser technology

LIGHT SPECTRUM
Wavelength (m)
Lasers
Television Short Wave Microwaves FM Radio AM Radio

10-6

10-3
Ionizing Radiation

1
Infrared

103

106
Radio Waves

109

Gamma Rays X-Rays Ultraviolet

Thermal/Heat Radiation

LASER SPECTRUM
Excimer 193 nm Argon 457-514 nm Diode Nd:Glass Er:Yag 805-820 nm 1053 nm 2940 nm CO2 10,600 nm

100 nm

400 nm

700 nm

100,000 nm

INTRALASE FS
Ultraviolet Visible Infrared

INTRALASE FS laser

Femtosecond laser

(Nd:Glass) 1053 nm (near infrared)

Each pulse of focused laser light lasts -15 approximately 10 seconds (500-800 femtoseconds)
In one second, light travels 7.5 times around the globe In 100 femtoseconds, light travels across a human hair Power = Energy/Time, extremely high power attained at relatively low energy

INTRALASE - FS 60

INTRALASE - FS 60
Model- FS 60
Repetition Rate- 60kHz Energy per pulse - > or equal to 1uJ

9mm flap time 17- 20 Degree

Hinge Angle - 30-90 Degree

Hinge location - Variable

Procedures - Flap, AK, Wedge, ICR, IEK, LK

INTRALASE - FS 60

Flap Shape - Planar

Visual Procedure Control - Yes Cut Direction - Interface first

Focus - X, Y, Z
Flap Thickness Control - Computer 90-400 uM Diameter Control - Computer

Cut Pattern - Raster/Spiral

Side cut angle - Computer 30-90

INTRALASE - FS 60
Beam pattern - Continuous
Centeration control -Computer software IOP increase vs microkerotomes -low Loss of sight during suction -Yes Docking arm - Automated

Mobile - No

LASIK / ZYOPTIX
Step 1 : Creating corneal flap Step 2 : Folds the flap back and perform laser procedure which corrects vision .

CORNEAL FLAP
Accuracy of thickness Flap Stability Nice / Sharp edges No complication Patient comfort during flap creation

HOW DO WE CREATE..
Equipment - Microkeratome Tissue cut by Blade Desired thickness - Blade Holder Flap Diameter Suction ring IOP increases > 65mmHg Total Time of Increased IOP ~ 60-80 sec.

LIMITATION
Meniscus flap Non Uniform Flap Thickness ~10 -35 Flap Diameter Steep corneas Deep set eyes Thin corneas with Higher ref correction

BLADE MICROKERATOME COMPLICATIONS

Microkeratome complications occur in up to 10 percent of all LASIK procedures, including the most serious complications that may affect the visual outcome of a LASIK procedure (Ambrosio and Wilson, Osman).

POSSIBLE COMPLICATIONS
Partial and Incomplete Flaps Free Flap Button Hole Suction Loss Epithelial Abrasion. Diff. thickness at different curvatures. Dry eye Problem

POSTPONE .????
If any of the Flap related complication occurs like incomplete flap, Button Hole, etc., the only option left is to reschedule the surgery.

INTRALASE
Blade free method Flap creation
Intralase FS laser is an advanced technology and represents a major improvement in LASIK surgery.
Offers versatile capability and flexibility in customizing flap creation with even, clean edges, regardless of the size or shape of the eye. With programmed parameters, the Intralase performs exactly as programmed with precise, predictable outcomes, transforming the science of creating the corneal flap into an artful application of technology. Patient Comfort -fast surgical procedure hence there is no trauma to the eye, no patient discomfort, patients tend to be very relaxed during the surgery, confident that the laser is performing as expected.

LOWER IOP
The suction ring used with the INTRALASE FS Laser creates an intraocular pressure (IOP) of approximately 40 mm Hg. In contrast, the suction ring used with a microkeratome raises IOP to 80 mm Hg or more, a much higher and potentially less safe level.

FLAP THICKNESS
Desired flap thickness accuracy ~ 5-10 In reality the thickness ~3-8

UNIFORM FLAP THICKNESS

The entire Cornea is applanated (flatten) uniformly then the laser works on planner surface.
The Highly precise Laser pulses focused to precise intrastromal locations. Flap is always uniform thickness from side to side . Furthermore the uniform thickness and Vertical cleavage plane fits the flap like a manhole cover, minimise the chance of flap slippage or wrinkling if accidentally rubbed or bumped during healing after surgery.

IMMEDIATE REPETITION WITH NO ADVERSE EFFECTS

If the surgeon encounters a loss of vacuum during flap creation with the Intralase laser, the flap creation can be repeated immediately with no known adverse affects. In contrast, complications occurring during the creation of a flap with a microkeratome may require three months of healing before a repeat procedure can be attempted.

REDUCED RISK OF COMPLICATIONS

As there are little to no possibilities of corneal abrasion, such situations as thin flap, thick flap, partial flap, incorrect diameter or buttonhole flap can be addressed.
In addition, with the resulting flap has uniform thickness across the diameter, use of the IntraLASIK approach is ideal for hyperopes, large pupils, moderate to high astigmatism, and small corneal diameters where producing a large enough flap for a blend zone is an issue. Producing a uniform ablation far into the periphery is critical in these cases.

EPITHELIAL INGROWTH - CONTROLLED

Further, the lasers ability to create a very thin flap maintains optimal stromal bed thickness when treating higher refractive errors or thinner corneas. Because the IntraLASIK 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.

EXCEPTIONAL SURGEON CONTROL

Surgeons gain exceptional control in the creation of corneal flaps.
The computerized IntraLASIK software allows the surgeon to set predictable controls for micron precision and consistency in flap diameter, depth, hinge location and width and side cut architecture, which varies by individual patient corneal anatomy.

Such precision virtually eliminates corneal flap complications.

INTRALASE IN EYE SURGERY

Intralase is not only used for Lasik for glass free vision but also for treatment of conical (keratoconus) cornea and corneal (eye) transplants for better results

PATIENTS GAIN CONFIDENCE

Patients gain confidence in choosing vision correction surgery.
The higher degree of comfort and safety, virtually no risk of complications, and more predictable outcomes increase patient satisfaction in their experience and outcome.

CONCLUSION
1. Major advancement in lasik 2. Higher degree of safety and precision 3. Predictable outcome

4. Faster visual recovery

5. Increased patient satisfaction and comfort

6. Enhanced quality of vision

7. Approved by FDA, NASA for astronaut and US air force