The evolution of photo disruption and its implementation in ophthalmology can be divided into multiple stages by measuring the pulse width duration to execute subsurface tissue alteration.
The Intralaser femtosecond laser was introduced in the year of 1987 for flap creation. Since then, four other refractive surgical femtosecond lasers have been launched in the market, such as The Femtec (Technolas Perfect Vision), The Femto LDV (Ziemer Ophthalmic Systems AG), The FS200 (Alcon Laboratories, Inc), and the VisuMax( By Carl Zeiss Meditec).
Ophthalmic femtosecond laser makes surgery minimally invasive and fast healing because there is no such cut & stitch and usage of blade. Femtosecond laser processes the target tissue and helps the surgeon execute the procedure within a 3-D screening without changing the surface.
Laser has become very famous in cataract surgery because it has two unique characteristics which bring evolution in medical science, i.e., (1) the nonlinear absorption process (2) Extremely high precision with a minimal side effect which causes the least energy required for photo disruption.
Laser's nonlinear absorption process allows eye surgeons to process the tissue three-dimensionally, which makes the procedure smooth and risk-free; this is different than linear absorption used in corneal remodeling.
Modern application of Femtosecond laser
Laser Cataract Surgery: This is the latest ophthalmic application of the femtosecond laser.Four different companies are paving the way in ophthalmology, such as OptiMedica Corp launched the Catalyst Precision Laser; LenAR launched the LensAR laser platform, Alcon laboratories launched the LenSX laser platform, & Bausch & Lomb launched the Invictus. All these lenses have become crucial in performing cataract & corneal refractive surgeries.
Treatment of tractional Vitreous attachments: Down the line, ultrashort laser pulses can be the substitute of posterior vitrectomy to correct the tractional vitreous attachments. Femtolaser helps surgeons make non-invasive surgery as laser pulses provide fewer incisions with the best precision. Laser surgery means less energy, less acoustic shock waves & less thermal damage.
Recently doctors have used adaptive optics for better beam delivery, and it is an better approach to eliminate optical aberrations.
Reversing Presbyopia: It is another super effective application of the Femtosecond laser in Presbyopia which can be reversed through the flexibility of the crystalline lens. A Femtosecond laser is performed by making a microincision inside the lens without any surgical opening in the affected eyes. These types of microchannels can minimize the internal friction of the lens and tissue as the sliding planes.
Refractive index shaping: A low-density plasma can be created through a femtosecond laser when its frequency is below the optical breakdown threshold. The low-density plasma allows free electrons to reciprocate with proximity tissues. The chemical reactions could slightly alter the refractive index of optical media, and this theory is used to transform a diffractive lens into a crystalline lens.
What are The Benefits of Femtosecond Lasers?
Better substitute for Microketaome Blade
The discovery of the femtosecond lens replaces the mechanical microkeratome blade. The blade technique has been there for LASIK procedures for so many years but with greater risk to the patients. The surgeon can operate on thin, curved, and flat corneas. Lasik treatment is a high-risk treatment because it involves cuts and stitches and requires prolonged healing time. The involvement of femtosecond laser delivers the best possibilities of surgery with reduced risk. Femtosecond laser creates minimal pressure on the eye, and its high precision prevents the chance of irregular cuts or unwanted cuts in corneal tissue.
Significant decrease in complications.
Flaps made with a mechanical blade are often linked with corneal complications such as a detached flap or free cap, the presence of a buttonhole, steep spots or central islands, small wrinkles or folds inside eyes or striae, along with infection. Femtosecond laser has become famous in eye surgery because it has minimal complications, virtually deleting very thick cap without making an incision, and prevents irregular cuts, which causes extra trauma inside the eyes.
It has a big influence on increasing patient safety and satisfying the laser's speed, which transmits ultrashort optical pulses with less than 1 picosecond. Making the Lasik flap with a femtosecond laser takes only 10 seconds for each eye. When a patient spends less time under the machine, eyes experience less trauma. Also, the femtosecond laser allows the surgeon to do an inverted bevel cut, making the cornea flap instead of pulling it back. When a surgery cornea flap gets involved, it reduces manipulation time with minimal risk of infection.
Fine-tuning with Femto laser increase precision
Femtosecond laser surgery makes a surgical procedure highly precise without cutting the tissue too thick. It helps to avoid post Lasikecstasia; it is a condition where the cornea starts to move forward& deteriorate vision. A femtosecond laser substantially eliminates the chance of ecstasy because it has a precise adjustment to the flap's diameter. All these features of a femto laser help the surgeon to bring better surgical outcomes avoiding unnecessary complications.
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