FEMTOLASIK STANDARD

The substantial difference between the FEMTOLASIK and the traditional LASIK consists in the way in which it realizes the corneal flap (flap). In fact, rather than opens to use a mechanical device such as the microkeratome, equipped with a steel blade oscillating, in FEMTOLASIK (i-LASIK) is used to create the flap a laser at said high frequency femtosecond which then resets every mechanical risk and allows to realize a corneal flap of greater precision and of smaller thickness (even only 90 microns) compared to the microkeratome (140-160 microns) which allows to have more healthy corneal tissue (uncut) and therefore more resistant over time to possible sfiancamenti of the back surface.
For the rest of the advantages of LASIK are undisputed, whether standard or customized, as the complete absence of post-operative pain, the immediate visual recovery, postoperative steroid therapy of short duration, the 'no risk' haze 'post-surgery (corneal opacity) and the less chance of regression of the results obtained.
• The preoperative examination
As for PRK and LASIK, and 'a crucial moment for the intervention in which, through careful and thorough examination is necessary to study not only the patient but also the refraction of a whole series of tests that might discourage intervention and FEMTOLASIK to direct the surgeon to a technique of photoablation of the surface or even to exclude the possibility of intervention.
We state all exams to be done:
Autorefrattometria
Is performed first with the pupil normally reagent and then dilation and possibly in cycloplegia.
Schiascopia
It 'a technique that allows assessment and measurement of refractive of' eye.
Keratometry
It 's useful for assessing the magnitude and regularity of astigmatism
Examination of visual acuity
It determines both the natural and the corrected visual acuity with best correction tolerated because it is this value that you are aiming to achieve with the intervention.
And 'one of the most important parameters to be evaluated each time you plan to correct a defect of vision with the excimer laser, already in the technique of surface ablation (PRK) one of his bad judgment could adversely affect the final result in night vision, in FemtoLasik, in addition to this, must also be considered the fact that the cut that the femtosecond laser is able to do never exceeds 9.5 -9.8 mm in diameter so that if the excimer laser produces a wide area of treatment with a good transition spots more peripheral area of ablated end up damaging the corneal epithelium and uncut especially without a transition effect.
Certainly compared to traditional LASIK, in FemtoLasik exists the undoubted advantage of creating a corneal flap exactly centered on the pupil, which is not always understood by using the microkeratome for which it is much easier that even a large treatment with the excimer laser does not fall to outside of the flap created.
The study of the pupil is made with a sophisticated tool called "pupillometer" which assesses the pupillary reactivity in different lighting conditions, from the scotopic (night) to photopic (daylight).
Where a pupil is found too large in patients with visual defects of a certain size may be necessary to exclude a FemtoLasik and think of a PRK or excluded entirely from the patient as a possible treatment with a very large pupil the laser should ablating a quantity of fabric so high that the cornea would be too dangerously thinned with the risk in the future of sfiancamenti or ectasia of the posterior corneal surface.
Slit-lamp biomicroscopy
This examination is necessary to exclude that the patient is suffering from some acute or chronic eye disease that could represent an absolute contraindication to intervention (keratitis, epithelial erosions and corneal dystrophies, corneal leucomas, anterior segment diseases, cataract).
Tonometry
It 'important to measure the intraocular pressure with a "applanation tonometry" or "blow" to exclude a disease glaucoma, LASIK is expected in the i-' s use of steroid eye drops for a few days and then there is the possibility of elevation of intraocular pressure as instead happens in the PRK where topical steroids is instilled for several months.
Examination of the fundus
E 'important to exclude pathologies of the central and peripheral retina and the optic nerve; for this purpose is used the lens with three mirrors Goldmann placed in contact of the cornea after instillation of some anesthetic eye drops to exclude regmatogene lesions of the peripheral retina, most likely in myopes, possibly requiring laser photocoagulation treatment, in i-LASIK should be more thorough in exploring the retinal periphery, as in this speech is expected to suck the eyeball completely immobilizes him before and during the action of femtosecond laser, however, raises the suction, even if for a few seconds, the intraocular pressure to about 30-35 mm of mercury reaching the 55-60 mm of mercury induced by the microkeratome and this is another definite advantage over the FemtoLasik to Lasik. It 'always good, however, that examination of the fundus does not escape any injury regmatogena the periphery of the retina because from that point you could have a major postoperative retinal pathology.
Pachymetry
Through a tool called "ultrasonic pachymeter" or with a computerized corneal tomography (Orbscan or Pentacam) Central corneal thickness is measured as very important to evaluate the feasibility of the intervention or not, a normal cornea measure from 500 to 600 microns thickness, and when this is lower than these values there may be an initial alteration of the cornea as a keratoconus worn and this is always worth attention; also, as already explained above, with a low pachymetry, a considerable myopia and a large pupil diameter could be should be excluded FemtoLasik and move towards a PRK and always prevent the laser treatment the cornea is too thin with the risk of corneal ectasia sfiancamenti or post-operative (posterior keratoconus). The advantage in FemtoLasik is that it is possible to program exactly the thickness of the corneal flap which is impossible using the microkeratome, and therefore having the possibility to realize flaps also of only 90 microns (a flap so thin implies a good manual dexterity of the surgeon for the danger that perforates ) compared to 160 microns in LASIK, many patients that was not possible to practice this technique can now be subjected to FemtoLasik with excellent results.

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FEMTOLASIK STANDARD

• The preoperative examination

We state all exams to be done:

Autorefrattometria

Schiascopia

Keratometry

Examination of visual acuity

Slit-lamp biomicroscopy

Tonometry

Examination of the fundus

Pachymetry

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VISUAL DEFECTS

Myopia

HYPERMETROPIA

ASTIGMATISM

Anisometropia

AMBLYOPIA

Presbyopia

REFRACTIVE SURGERY

Femtosecond laser

LASER EXCIMER

PRK

PRK STANDARD

PRK CUSTOMIZED

LASIK

LASIK STANDARD

LASIK CUSTOMIZED

I-LASIK

FEMTOLASIK STANDARD

CUSTOMIZED FEMTOLASIK

CATARACT

GLAUCOMA

Keratoconus

MACULAR DEGENERATION

STRABISMUS

Diabetic Retinopathy

DISEASES lacrimal

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