ISBN-10:
1556428626
ISBN-13:
9781556428623
Pub. Date:
03/01/2009
Publisher:
SLACK, Incorporated
Femtodynamics: A Guide to Laser Settings and Procedure Techniques to Optimize Outcomes with Femtosecond Lasers / Edition 1

Femtodynamics: A Guide to Laser Settings and Procedure Techniques to Optimize Outcomes with Femtosecond Lasers / Edition 1

by Ella G. Faktorovich

Hardcover

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Product Details

ISBN-13: 9781556428623
Publisher: SLACK, Incorporated
Publication date: 03/01/2009
Pages: 264
Product dimensions: 7.30(w) x 10.20(h) x 0.70(d)

About the Author


Ella G. Faktorovich, MD is a corneal and refractive surgeon in San Francisco, CA. She received her B.A. in Molecular Genetics from UC Berkeley, where she was elected Phi Beta Kappa, and her medical degree from UC San Francisco School of Medicine, where she was elected Alpha Omega Alpha. While a medical student, Dr. Faktorovich developed techniques for retinal transplantation and intraocular injection of growth factors to rescue photoreceptors in eyes with retinal degeneration. She completed her residency in ophthalmology at the UC San Francisco School of Medicine, where she became interested in refractive surgery. She then completed a fellowship in cornea, external diseases, and refractive surgery at the Jules Stein Eye Institute UCLA School of Medicine. During her fellowship, Dr. Faktorovich pursued research on corneal wound healing and methods of pain control after refractive surgery.

Upon returning to San Francisco, Dr. Faktorovich established Pacific Vision Institute, where she has worked since. She is the founder and remains the Chair of the San Francisco Cornea, Cataract, and Refractive Surgery Symposium, which is currently in its 8th year and brings together the leaders in corneal and lens surgery. In addition to her busy clinical work, Dr. Faktorovich remains active in multiple research projects. She enjoys finding innovative solutions to common and uncommon dilemmas in corneal and refractive surgery.

Table of Contents

Contents
Dedication
Acknowledgments
About the Author
Foreword by Barry S. Seibel, MD
Preface

Chapter 1: History and Applications of Femtosecond Lasers
Principles of Laser-Matter Interaction
Femtosecond Lasers
Applications of Femtosecond Lasers

Chapter 2: Femtosecond Lasers in Corneal Surgery
Introduction
Mechanism of Corneal Femtodissection
Femtosecond Laser Systems for Corneal Femtodissection
Femtosecond LASIK Flap
Femtosecond Channels for Intracorneal Ring Segments
Femtosecond Corneal Transplantation and Other Procedures

Chapter 3. Principles of Femtodynamics
Overview
Centration Process
Quality of Dissection
Opaque Bubble Layer
What Is OBL and Where Does it Come From?
OBL Due to High Energy
OBL Due to Low Energy
OBL as a Guide for Optimizing Laser Settings and Procedure Techniques
Postoperative Findings

Chapter 4. LASIK With AMO Femtosecond Lasers: Laser Settings
Technical Features of AMO Laser Systems (Intralase and iFS)
Overview of Laser Settings for LASIK Flap Creation
Pocket Specifications
Overview
Pocket On/Off
Pocket Depth
Pocket Width
Pocket-Flap Overlap
Pocket Ramp
Spot Separation
Pocket Energy
Pocket Position
Hinge Parameters
Overview
Hinge Angle
Hinge Position
Flap Bed Parameters
Overview
Flap Bed Laser Pulse (Spot and Line) Separation
Flap Bed (Raster) Energy
Flap Diameter
Flap Thickness
Flap Thickness in Corneas With Scars and Epithelial Basement Membrane Dystrophy
Flap Side Cut Parameters
Side Cut Angle
Side Cut Energy

Chapter 5. LASIK With AMO Femtosecond Lasers:
LASIK Procedure Techniques
Overview
Positioning the Suction Ring
Overview
Centering on the Line of Sight
Strategies for Maximizing Stromal Bed Exposure in Eyes With Decentered Line of Sight
Docking the Applanation Cone
Overview
Head and Eye Position
Applanation
Avoiding Parallax Error During Docking
(Contributed by Barry S. Seibel, MD)
Meniscus
Avoiding False Meniscus
Fine-Tuning Flap Centration on the Video Display
Moving the Pocket Close to the Meniscus
Centering the Flap on the Optical Zone
Lifting the Flap
General Principles
Two-Step Technique
One-Step Technique
Repositioning the Flap
General Principles
Technique 1
Technique 2
Repositioning the Flap if Stretch Striae are Present
Enhancement Techniques

Chapter 6. LASIK With AMO Femtosecond Lasers: Getting Started
Overview
Mastering Applanation
Mastering Flap Lift
Optimizing Energy Settings: Where to Begin?
Postoperative Findings
Summary

Chapter 7. LASIK With AMO Femtosecond Lasers: Troubleshooting
Problem 1: OBL
Causes
Solution
Pocket OBL
Pocket/Bed OBL
Bed OBL
Pocket OBL
Pocket/Bed OBL
Bed OBL
Problem 2: OBL in the Area of Ablation, Tracking, or Iris Registration
Causes
Solution
Problem 3: Difficult Flap Lift/Flap Lift in the Area With OBL
Causes
Solution
Problem 4: Flap Stretch
Causes
Solution
Problem 5: Flap Striae
Causes
Solution
Problem 6: Flap Tear
Causes
Solution
Problem 7: Peripheral Tags
Causes
Solution
Problem 8: OBL, Difficult Flap Lifts, and Peripheral Tags Despite
Optimized Laser Settings and Techniques
Causes
Solution
Problem 9: Loss of Suction
Causes
Solution
Problem 10: Vertical Gas Breakthrough
Causes
Solution
Problem 11: Horizontal Gas Breakthrough
Causes
Solution
Problem 12: Bubbles in the Anterior Chamber
Causes
Solution
Problem 13: Difficulty Tracking and Iris Registration During
Excimer Laser Ablation
Causes
Solution
Problem 14: Subconjunctival Hemorrhage
Causes
Solution
Problem 15: Decreased Visual Acuity at Postoperative Day One
Causes
Solution
Problem 16: Peripheral Lamellar Keratitis
Causes
Solution
Problem 17: Transient Light Sensitivity Syndrome
Causes
Solution

Chapter 8. LASIK With Emerging Femtosecond Laser Systems
Ziemer Femto LDV
Technical Features of Ziemer Femto LDV Laser System
System Settings for LASIK Flap Creation
Procedure Techniques for LASIK Flap Creation
Trouble Shooting
VisuMax
Technical Features of VisuMax Laser System
Overview of LASIK Flap Creation
Femtec
Technical Features of the Femtec Laser System
Overview of LASIK Flap Creation

Chapter 9. Intracorneal Ring Segments
Overview
Laser Settings
Procedure Techniques

Chapter 10. IntraLase-Enabled Laser Keratoplasty
(Contributed by Roger F. Steinert, MD)
Overview
Development
Penetrating Keratoplasty
The Zig-Zag Incision Pattern
Surgical Technique
Lamellar Keratoplasty
Overview
Surgical Technique
Future Directions

Chapter 11. Future of Femtosecond Laser Technology
Femtosecond Lenticular Extraction
Femtosecond Laser Astigmatism Correction (FLAC)
Femtosecond Laser Intrastromal Correction of Presbyopia (intraCOR)
Femtosecond Lens Surgery (FLeS)
Femtosecond-Assisted Corneal Biopsy (FAB)
Femtosecond-Assisted Limbal Stem Cell Harvesting
Femtosecond Glaucoma Surgery
Femtosecond-Assisted High Resolution Tissue Imaging

Glossary
Index

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