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Femtosecond Lasik
What is the femto second lasik Method?
The femto second  laser  is a  technique used to perform the first step in lasik  creating  a corneal flap preparing  the eye for the second step , where an Excimer laser is  used on the cornea to correct refractive error and improve vision.
 
How does the femto second lasik Method work?
The femto second laser uses tiny, very rapid pulses of laser to create a corneal flap.
Each pulse of laser passes through the  layers of the cornea and forms a microscopic bubble at a specific depth and position  determined by the doctor, creating a uniform layer of bubbles  beneath the corneal surface.
The doctor creates a corneal flap by gently separating the tissues where those bubbles were formed. The corneal flap is  folded back so the doctor can perform  Excimer Laser treatment that can also be customized to the person's own cornea.
 
What is the difference between a corneal flap created with the femto second Laser  and one created with a microkeratome?
The microkeratome is a hand-held instrument, which moves back and forth to create a cut in the cornea.  A microkeratome is only capable of making a single, one-dimensional cut across the cornea.
On the other hand, the femto second laser creates a precisely positioned layer of bubbles  beneath the surface of the eye thus creating a smooth  surface after the flap is lifted.
Are there other benefits of  the femto second lasik ?
Safety: As there is no actual cutting of the cornea, but only a layer of gas bubbles, no damage occurs if the procedure has to be aborted at any stage . The procedure can be reapplied either during the same cession or after few minutes . 
If the surgeon decides to postpone the procedure, the gas bubbles are absorbed and the patient returns to normal in few hours .

Accuracy: The surgeon can determine , with a range of only few microns, the exact thickness of the flap . This allows the surgeon to correct higher errors in patients with thin corneas and yet maintain a safe residual thickness of cornea. 

Ability to tailor the procedure to your eyes: The femto second lasik  gives your doctor
the ability to tailor the dimensions of the corneal flap based on what's best for your eye. Everything from the diameter of your flap to the angle of its edges can be precisely determined. This is important because everyone's eyes are shaped a little differently.
Having a corneal flap that's individualized to the patient contributes to excellent postoperative outcomes.
In addition, a corneal flap created with the femto second lasik  also (locks)back into position after the LASIK procedure is performed making it more stable especially for those who are actively involved in contact sports.

No pressure on the eye: Patient maintains fixation throughout the whole procedure with No pain or momentary blackout as with the Microkeratome . This makes the technique more suitable and safer  for patients with high myopia and astigmatism when no pressure should be applied on the retina . 

Not affected by corneal curvature or high astigmatism: This also allows the surgeon to do LASIK in patients with very steep or very flat corneas that would ,otherwise, have been impossible to be treated  safely with the standard Microkeratome LASIK.

Less corneal Dryness: Due to the ability of making  thin and small flaps there is less effect on corneal nerves and therefore less dryness than that in cases of classic microkeratome LASIK .   

Better vision: More patients in clinical studies achieved  20/20 (6/6) vision or better  with the femto second lasik   than in cases with mechanical Microkeratome.

Better Quality of Vision: Because of All  these advantages and the ability to combine a Customized flap with a Customized Excimer laser treatment , more patients observe better quality of vision with less glare and good night vision.
 
How long does it take to create a flap using the femto second lasik ?
The creation of the flap itself takes only about 15-30 seconds per eye. Including preparation time, the entire LASIK procedure takes about 10 minutes for both eyes.
 
Is the femto second lasik Method right for me?
If you are looking for a safe , accurate and more comfortable  LASIK experience , the answer is yes. But to get this procedure, you have to ask your doctor for the femto second lasik.
 
Applications:
1- Lasik Flaps
Corneal flap creation in LASIK surgery is the most common application of the FS laser.
The major advantages of the femtosecond laser flap creation over the mechanical
microkeratome are:
- Reduced incidence of flap complications, such as buttonholes, epithelial abrasions, short flaps, free caps, blade marks, and irregular cuts.
- Greater surgeon choice of flap diameter and thickness, side cut angle, hinge position and length, spot size and separation, and firing patterns (spiral vs raster).
- Absence of moving parts.
- Increased precision with improved flap safety and thickness.
- A capability of cutting thinner flaps (90µm or even less) to accommodate thin corneas
and/or high refractive errors.
2- All Femtosecond Lasik (Flex and Smile)
3- Lamllar Keratoplasty
For anterior lamellar keratoplasty (ALKP), the laser is programmed to create anterior lamellar interface and peripheral trephination cuts of desired depths and diameters. Laser treatment begins with formation of the lamellar cut at a depth determined by the corneal opacities to be removed.
4- Penetrating Keratoplasty
FS laser creates straight trephination cuts or complex-pattern trephination cuts for enhanced wound integrity of the graft-host junction. The choice of shapes and diameters is dependent on individualized clinical requirements. The patterned trephination is thought to not only increase the strength and structural integrity of the graft-host junction, but to also reduce the number of requisite sutures, lessen the amount of astigmatism, and possibly shorten the time of visual recovery.
5- Intra Corneal Ring Segments
- The FS laser may be programmed to create arcuate tunnels for implant placement
at approximately 70% corneal depth.
- The tunnel creation with the laser is easier, more precise, more predictable, and less likely
to perforate the cornea than with the traditional mechanical spreader method.

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