Femtosecond Laser Flap Making

what does "femtosecond laser flap making" mean? is this a new technique?

Doctor Answers 5

Femtosecond laser intraLase i-LASIK

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the femtosecond laser is used to cut LASIK flaps with a laser instead of a metal blade. this is also called IntraLase (after the #1 femtosecond laser company) or i-LASIK (a trademarked term by VISX, which bought IntraLase, and was then bought by AMO)

this laser was created to reduce the chance of a flap complication, and it has. unfortunately, the only way to eliminate, rather than reduce the chance of a flap probem, which is the most frequent problem in LASIK, is to not cut a flap at all, which is what the newer, safer, noncutting LASEK and epiLASEK procedures allow

Emil Chynn, MD, NYC


New York Ophthalmologist

LASIK Flaps created by a Laser

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Simply put, a "femtosecond flap" is a flap created by a Laser and not by a mechanical blade. It is not necessarily a new technique but it has gained some popularity in the past few years. Initially thought to offer a safer result than a conventional Microkeratome, with today's advancements in technology there is very little difference in safety. Both methods are extremely safe for most patients. Certain cases may require the use of one technology over the other. We currently offer the choice of technology to our patients.

How the Femtosecond Laser works:

We use computer software to guide the femtosecond laser beam, which applies a series of tiny bubbles within the central layer of the cornea. The resulting corneal flap is created at a precise depth and diameter pre-determined by the surgeon.

As occurs with a mechanical microkeratome, a small section of tissue at one edge of the flap is left uncut, forming a hinge that allows the surgeon to fold back the flap so the cornea can be accessed and reshaped for vision correction.

Next a separate laser (an excimer laser) will reshape the corneal tissue based on a variety of factors.

There are (4) Femtosecond Lasers on the market today:

• Intralase - gained FDA approval in 2001. It was the first FDA Femtosecond Laser in the United States.

• zLASIK - Ziemer Ophthalmic Systems received FDA approval in March 2008 for its portable femtosecond laser, known as the Ziemer Femto LDV. This femtosecond laser attaches to a movable arm and can be combined with any approved excimer laser system to create a flap for bladeless LASIK.

• Femtec - This femtosecond laser from 20/10 Perfect Vision received FDA clearance in 2004 and also can be combined with an approved excimer laser system for bladeless LASIK procedures.

• VisuMax - FDA-approved in 2007, the VisuMax femtosecond laser system typically is combined for bladeless LASIK with the Carl Zeiss Meditec Mel 80 excimer laser outside the United States. The Mel 80 received FDA approval in 2006. Company officials in late 2008 announced positive results at three U.S. centers where the combined laser systems have been used for bladeless LASIK.

Recovery is similar to that of traditional LASIK. Following surgery, some people (as with traditional LASIK) have reported feeling eye irritation for up to two days.

Please let me know if you have any additional questions.

Best Regards,

Robert T. Lin, M.D.
Assistant Clinical Professor, UCLA
IQ Laser Vision

Robert T. Lin, MD
City Of Industry Ophthalmologist

Femtosecond laser is a relatively new laser

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The femtosecond laser is a relatively new laser (like Intralase) for making LASIK flaps.  So, blades are not necessary.

Christopher Coad, MD
New York Ophthalmologist

Femtosecond Technology for LASIK and Cataract Surgery

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A "Femtosecond Laser" is a type of laser used in both Laser Vision Correction(LASIK) and, more recently, cataract surgery. I have been using a femtosecond laser to make the corneal flap, that is the first step in the LASIK procedure, since 2003. This laser replaced the mechanical method that was performed in the 1990's and has been a wonderful breakthrough in both safety, accuracy, as well as patient acceptance. So, while this is not a new technique, it is certainly the preferred technique when performing LASIK.

You will be hearing alot more about femtosecond technology in the near term, as it relates to cataract surgery. We are at the beginning of a complete paradigm shift in how cataract surgery is performed. For the past 30 years cataract surgery has been performed using an ultrasound process known as phacoemulsification. Several femtosecond lasers have recently been FDA approved to do a significant portion of the cataract procedure and, I believe, this will rapidly become the preferred technique over the next 3-5 years. I will be writing alot more about this topic. It is an exciting time to be involved with this technology!

Anthony J. Kameen, MD
Baltimore Ophthalmologist

Femtosecond laser is a safer, more predictable technique

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The femtosecond laser is a very precise and highly predictable means for cutting the LASIK flap. Even though very good results can still be achieved with the more traditional microkeratome which uses a metal blade to cut the flap, many surgeons agree that the femtosecond laser is a safer and more predictable technique. In 2010, for the first time, more LASIK flaps were cut with femtosecond lasers than microkeratomes in the US.

Christopher Starr, MD
New York Ophthalmologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.