Femtosecond Laser

The femtosecond laser allows performing capsulotomies, fragmentation of the corneal nucleus, arched incisions, corneal ring tunnels and flaps for corneal rings. cataractThe femtosecond laser allows capsulotomies, arch incisions, corneal incisions, tunnels for corneal rings and flaps for LASIK.

Technically, the femtosecond laser emits pulses of extremely short duration, transferring no heat or any mechanical effect to the treated structures. The procedure is therefore very fast, increasing the safety of the surgery, reducing patient anxiety.

At CPO we use a femtosecond laser of the latest generation, the VICTUS, which allows all the above procedures to be performed on the same platform, with high efficiency and excellent results.

There are numerous advantages in the use of the femtosecond laser for the surgeon, namely a OCT intraoperative high contrast, which allows a detailed intraoperative view, during the whole procedure, facilitating the control and planning of the surgery.

The software allows centering, capsulotomy and nucleus fragmentation in the pupil, limbus or apex of the cataract or at any other point chosen by the surgeon. The centration in the case of the flap is automatic, achieving greater precision, eliminating the need for manual positioning. It is also possible for the doctor to choose the type of core fragmentation that is most suitable for the type of cataract and the technique used to remove the core fragments afterwards.

The femtosecond laser (VICTUS) software allows:

• Visualisation of the procedure;
• Automatic pupil recognition;
• Optimum visual adjustment through graphic interface and OCT high-contrast;
• Arched incisions with precision in depth, length, diameter and axis adjustment.

The corneal flattening (i.e. compression contact) interface is dry (as opposed to other lasers that require fluid to interface), has pressure sensors to prevent excessive compression of the cornea, which can cause back-face folding or conjunctival bleeding

When obtaining the flap for the LASIKA complication can occur when the cut is incomplete, off-centred or irregular. The femtosecond laser does not cut, it only separates the layers of the cornea. In these cases manual separation and lifting of the flap is not necessary. After several minutes the cornea returns to its normal appearance without any change. It is then possible to repeat the procedure as if nothing had happened. This is a huge advantage compared to the old mechanical process with the microkeratome.

There can be complications, although very rare in the use of the femtosecond laser, especially in cataract surgery and it also has some contraindications.

Its use is contraindicated in cases of paediatric surgery, ocular hypotonia, glaucoma, retina diseases, rheumatic diseases, presence of any type of corneal implant, corneal opacities and nystagmus.

Corneal diseases such as endothelial dystrophies, o keratoconusopacities and history of ocular herpes, are situations that either prevent a correct flattening of the cornea or They prevent a good visualization of the structures, thus preventing the use of the laser.

Still in relation to cataract surgery cataract we have to consider the cases in which it is impossible to achieve an adequate pupil dilation which makes capsulotomy and nucleus fragmentation impossible.

Complications of cataract include incomplete capsulotomy or displacement of the capsule, interruption of fragmentation and rupture of the posterior capsule.

Any of the previous situations does not affect the final result, as it is always possible to continue the surgery as we did without the laser. The last one, on the other hand, involves the use of vitrectomy to remove the remnants of the cataract that end up in the vitreous.

It is therefore a safe adjunct to precision surgery for both cataract as in LASIK.