Femto-Lasik laser surgery: how does it

work?
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Femto-Lasik is the most recent ocular laser technology intended for people who cant see
without glasses or contacts.

Whether you suffer from short-sightedness (myopia), long-sightedness

(hypermetropia/hyperopia), astigmatism, or age-related long-sightedness (presbyopia): all
these sightedness conditions can be treated with the Excimer laser and without problem.

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What is an Excimerlaser?
With the Excimerlaser we vaporise a thin layer of the cornea.

By so doing, we can:

change the profile of the cornea.

flatten its profile in cases of short-sightedness.
round out its profile in cases of long-sightedness.
even out its profile in cases of astigmatism.

What is a Femto-Lasik procedure?

Femto-Lasik, or Z-Lasik, is the newest type of ocular laser used to treat your sight problems.

Earlierwith the older laser-techniqueslaser eye surgery started first on the surface of the
cornea, and thereafter went deeper via a flap made in the cornea. In this older technique, the
flap would be made by hand, with a scalpel.

With Femto-Lasik laser eye surgery, we make the flap in the cornea with the newest type of
laser: the Femto-Second. The Lasik procedure is now even safer: there are much fewer risks
of complications during the procedure and the flaps are much thinner. This offers a better
chance of greater stability to the cornea over time.

How does a Femto-Lasik laser work?

The Femto-Lasik laser operates on the principle of photo-disruption: with infra red laser
energy the surgeon creates a precise pattern of small, overlapping spaces just under the
surface of the cornea. The laser works at extremely fast speeds: pulses of 1 quadrillionth of a
second or 1 femtosecond.
These precision guided pulses of laser light break down the corneal tissue at the molecular
level each femtosecond, without generating heat or interfering with surrounding tissue. When
the laser moves over the eye, it incises a completed flap in the cornea. Once this flap has been
created, the surgeon can tilt it up with a specially designed surgical tool. Thereafter the
Excimer laser is used to re-sculpt the cornea and correct eye problems. Finally the surgeon
puts the flap back in its place.

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Advantages to the Femto-Lasik procedure

1. Greater safety

Significantly reduced risk of problems with the corneal flap

Reduced risk of inflammation or infection
Larger treatment surface with better stability
Less need for repeat treatment

2. Thinner flaps

With the Femto-Lasik, the corneal flap is so thin and so cleanly incised that no side effects
generally result. With thin flaps more tissue-bed is left over. This offers a greater guarantee
of the stability of the cornea over the long term and makes it possible to correct a wider range
of vision impairment.

3. Better predictability to flap thickness

The surgeon knows in advance and with certainty the form, the thickness, the size, and the
condition of the flap. This is relevant to the treatment strategy for higher levels of vision
impairment. Where the flap is incised by scalpel, it is only afterwards that the surgeon can
judge what the flap looks like.

4. Other advantages

The dimensions of the eyeball are not important for Femto-Lasik eye surgery.
Your recovery is faster and you can begin to see properly again sooner.
The outcomes for vision are excellent.
With the Femto-Lasik laser less pressure is put on the eye during surgery, and this
means more comfort for the patient

What are the steps in a Femto-Lasik procedure?

Before surgery

The day of the procedure we do the pre-operative measurements once more.

Thereafter you receive a light sedative (Xanax 0.5mg). Your eyes are given local
anaesthetic. You do not therefore have to undergo any general anaesthetic
During surgery

Nursing staff will help you to the operation bed in the laser treatment room.
Your eyes are thoroughly disinfected and covered with a sterile bandage.
Your eyelashes are held out of the way and your eyes are given a further dose of local
anaesthetic.
A device holding the eyelids is set in place to stop blinking and closing of the eye.
Making the corneal flap takes 26 seconds and uses a device which is placed on the
eye. So you dont need to worry: you cannot interfere in any way with the positioning
of this instrument.
After opening the flap, the surgeon uses the WavelightExcimerlaser to treat your
particular eye condition. This involves you looking at a targeting light for 1 second,
and thereafter the laser will automatically follow the movement of your eye.
Finally, the flap is folded back, rinsed well, and fixed into place.

After Surgery

You are brought to the recovery and relaxation zone where you rest for about 30
minutes.
You should not drive the day of the procedure, so its best to come accompanied by
family or friend! Taking public transport is also not recommended.
The post-operative medication is eye drops and protective eye glasses which you must
wear for 24 hours.
The complete procedurefrom arrival to departuretakes 2hours.

Follow-up examinations after the operation are scheduled for after the first day, after one
week, and after two to three months.

These follow-up examinations are included in the total package!

Femto-Lasik options: A-Cat, T-Cat and Lasik Extra

A-Cat: Aberrometry-guided Femto Lasik

Now available is a highly sophisticated piece of diagnostic equipment which can measure
very fine, small-scale impairment in vision.These aberrations exist on such a microscopic
level that neither glasses nor contact lenses can correct them. Treating significant visual
impairment (the A-Cat option) in persons with large pupils / diameter can give them more
contrast in their night-vision. Your surgeon will discuss this option with you if he thinks it
can help improve your sight.

T-Cat: Topography-guided Femto-Lasik

Generally, your cornea has a regular (spherical and toric) shape. With certain patients we can
also identify from topographic imaging an asymmetric or irregular astigmatism, as is the case
with keratoconus. Your surgeon will discuss the T-Cat procedure with you if he thinks this
option can help improve your vision.
Lasik-Extra: Avedro

With Femto Lasik therapy for hypermetropia and presbyopia, a partial regression in the result
could occur after a number of years. Up to now, surgeons would perform a further corrective
procedure.

That is no longer necessary, thanks to the Avedro-UV Crosslinking technique. For this
technique, we bathe the eye with UV radiation after the Lasik procedure which then brings
about a bonding of the collagen fibres in the cornea. This generates a stabilization of the new
cornea shape