Transcript Document

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 (µm)
Lasers
10-6
10-3
Gamma RaysX-Rays Ultraviolet
Ionizing Radiation
Television Short Wave
Microwaves FM Radio AM Radio
103
1
Infrared
106
Radio Waves
Thermal/Heat Radiation
109
LASER SPECTRUM
Excimer
193 nm
100 nm
Argon
457-514 nm
Diode
Nd:Glass Er:Yag
805-820 nm 1053 nm 2940 nm
700 nm
400 nm
100,000 nm
INTRALASE ® FS
Ultraviolet
Visible
CO2
10,600 nm
Infrared
®
INTRALASE FS laser
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Femtosecond laser
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(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
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Flap Shape - Planar
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Visual Procedure Control - Yes
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Cut Direction - Interface first
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Focus - X, Y, Z
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Flap Thickness Control - Computer 90-400 uM
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Diameter Control - Computer
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Cut Pattern - Raster/Spiral
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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
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Accuracy of thickness
Flap Stability
Nice / Sharp edges
No complication
Patient comfort during flap creation
HOW DO WE CREATE…..
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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
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Meniscus flap – Non Uniform
Flap Thickness ~10 -35 µ
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
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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 ~ 5-10µ
• In reality the thickness ~3-8µ
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 laser’s 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