Blade Free

7/28/2019 Blade Free

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LOTUS EYE CARE HOSPITAL

LAUNCHED

BLADE FREEINTRALASE LASIK/ ZYOPTIX

TECHNOLOGY


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(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

FEMTOSECOND


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10-3 103 106 109110-6Thermal/Heat RadiationIonizing Radiation

Gamma Rays

X-Rays

Ultraviolet Infrared Radio Waves

MicrowavesTelevisionFM Radio Short WaveAM RadioLasersWavelength (m)

LIGHT SPECTRUM


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Ultraviolet Visible Infrared

100 nm 400 nm 700 nm 100,000 nm

INTRALASE FS

Argon

457-514 nm

Diode

805-820 nm

Er:Yag

2940 nm

Nd:Glass

1053 nm

CO2

10,600 nm

Excimer

193 nm

LASER SPECTRUM


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INTRALASEFS laser

Femtosecond laser

(Nd:Glass) 1053 nm (near infrared)

Each pulse of focused laser light lasts

approximately 10-15 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


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INTRALASE - FS 60


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Model- FS 60

Repetition Rate- 60kHz

Energy per pulse - > or equal to 1uJ

9mm flap time17- 20 Degree

Hinge Angle - 30-90 Degree Hinge location - Variable

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

INTRALASE - FS 60


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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


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Beam pattern - Continuous

Centeration control -Computer software

IOP increase vs microkerotomes -low

Loss of sight during suction -Yes

Docking arm - Automated

Mobile - No

INTRALASE - FS 60


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LASIK / ZYOPTIX

Step 1 : Creating corneal flap

Step 2 : Folds the flap back and perform laserprocedure which corrects vision .


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CORNEAL FLAP

Accuracy of thickness

Flap Stability

Nice / Sharp edges

No complication

Patient comfort during flap creation


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HOW DO WE CREATE..

Equipment - Microkeratome

Tissue cut by Blade

Desired thickness - Blade Holder

Flap DiameterSuction ring

IOP increases > 65mmHg

Total Time of Increased IOP ~ 60-80 sec.


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LIMITATION

Meniscus flapNon Uniform

Flap Thickness ~10 -35

Flap Diameter

Steep corneas

Deep set eyes

Thin corneas with Higher ref correction


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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).


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POSSIBLE COMPLICATIONS

Partial and Incomplete Flaps

Free Flap

Button Hole Suction Loss

Epithelial Abrasion.

Diff. thickness at different curvatures. Dry eye Problem


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POSTPONE .????

If any of the Flap related complication

occurs like incomplete flap, Button Hole,

etc., the only option left is to reschedule thesurgery.


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INTRALASE

Blade free method Flap creation

Intralase FS laser is an advanced technology and represents a majorimprovement 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 asprogrammed with precise, predictable outcomes, transforming thescience 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 duringthe surgery, confident that the laser is performing as expected.


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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.


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FLAP THICKNESS

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


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UNIFORM FLAP THICKNESS

The entire Cornea is applanated (flatten) uniformly then the laserworks 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 flapslippage or wrinkling if accidentally rubbed or bumped duringhealing after surgery.


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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 thecreation of a flap with a microkeratome may

require three months of healing before a repeat

procedure can be attempted.


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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 thicknessacross the diameter, use of the IntraLASIK approach isideal for hyperopes, large pupils, moderate to highastigmatism, and small corneal diameters where producinga large enough flap for a blend zone is an issue.

Producing a uniform ablation far into the periphery iscritical in these cases.


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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 thelaser to produce flaps with vertical edges, it is

more difficult for epithelial cells to migrate downunder the flap into the interface since the length ofthe route for those cells is increased.


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EXCEPTIONAL SURGEON

CONTROL Surgeons gain exceptional controlin the creation of

corneal flaps.

The computerized IntraLASIK software allows the surgeonto set predictable controls for micron precision andconsistency in flap diameter, depth, hinge location andwidth and side cut architecture, which varies by individual

patient corneal anatomy.

Such precision virtually eliminates corneal flapcomplications.


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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


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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.


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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


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