Femto Laser Assisted Cataract Surgery (FLACS)
Initially used in LASIK surgery, femtosecond laser technology has evolved to offer the latest technique in performing cataract and lens replacement procedures, providing unprecedented accuracy and precision.
The Ziemer Z8 laser can now be used to complete some of the critical steps of cataract and lens replacement surgery with repeatable accuracy down to 1/1000th mm. This includes the entry incisions, capsulorhexis and softening or fragmenting the nucleus. These lasers use very short pulses (femtosecond) of energy, which create tiny gas bubbles and employ the same principles that we have been using in LASIK for some years.
For patients seeking the most advanced and accurate surgical procedure, laser cataract surgery is at the forefront and remains unsurpassed. This technology offers a reproducible technique to replace the less predictable and most technically demanding steps of conventional cataract surgery.
What are the advantages of laser cataract surgery?
Femtosecond laser assisted surgery offers several distinct advantages over conventional surgery.
The femtosecond laser not only creates precise accesses to the interior of the eye, it also fragments the clouded lens in such a way that it can be ultimately removed with very little or even no ultrasonic power. This means less strain on the sensitive tissues and structures of the eye thereby helping to prevent an inflammatory response.
Predictability and unprecedented accuracy
The eye is carefully measured and the measurement data programmed into the laser. By doing this in advance, the surgeon can plan, supervise and guide your unique and individual treatment from start to finish.
Ultimate precision to 1/1000th mm
A more precise surgery makes it more likely that the artificial lens will remain stable and provide the best possible
vision. Using the femtosecond laser, surgeons can achieve the perfect capsule shape, size and position for lens fragmentation.
The high precision openings created help reduce conventional issues with incisions and allow the surgeon to perfectly align the artificial lens in the eye.
The laser can create the perfect shape and dimensions for the ports required to access the cataract without the need for sharp blades.
Individualised and tailored treatment plans
We provide treatment specifically made for your eye. The laser’s versatility allows us to precisely pinpoint the locations at which it will separate the tissues, ensuring a custom procedure perfectly designed for your eye.
The fragmented lens is removed by aspiration and irrigation. The artificial lens is inserted with an injector.
Understanding the Ziemer difference
Unique low energy laser technology for better outcomes
FEMTO LDV lasers are designed for maximal precision and gentle eye surgery. Ziemer laser technology is known for:
- Low energy per pulse in the nJ range for gentler treatments
- High repetition rate in the MHz range for fast procedures
- Overlapping laser spots for complete and smooth resections
Small laser spots with low pulse energy
The FEMTO LDV Z Models feature a handpiece which works very close to the eye. Because of this, the laser only needs low energy pulses. This allows to overlap the laser spots and therefore have a smooth and complete cut.
As a comparison conventional laser systems use high energy pulses which cannot overlap and therefore have tissue bridges between the spots.
Overlapping laser spots for complete resections
Different from other lasers, the FEMTO LDV Z Models feature overlapping laser spots that result in:
- Complete resections
- No tissue bridges
- High precision and predictability
Image: Very smooth capsule edges created by the FEMTO LDV Z8
Flexible adaptation to patients
The unique handpiece is mounted to the articulated arm and enables for:
- Intuitive docking to the patient’s eye unaffected by patient size or positioning
- More convenient especially for
- Patients suffering from claustrophobia
- Patients with nystagmus
- Perpendicular docking to the patient’s eye making the occurrence of situations like lentodonesis easily manageable
- Stable, computer controlled vacuum even in difficult cases
Image-guided surgery with OCT
The Ziemer spectral domain OCT system is highly specialized for corneal and lens surgery and custom made for the FEMTO LDV Z8.
Surgical planning by OCT imaging
The Ziemer spectral domain OCT system is highly specialized for corneal and lens surgery and custom made for the FEMTO LDV Z8. Advantages are:
- Enhanced surgical planning
- Clear visualization of previous resections (e. g. LASIK-flaps or keratoplasties) and scars
- Increased planning options for ultra-thin resections
- Automatic edge detection (pupil, limbus, cornea, lens and iris)
- Resection geometry placement automatically suggested by the planning software based on the individual surgeon’s preferences and the patient’s eye
High definition images for tailor-made surgery
The integrated high resolution camera attributes for:
- Better visual control
- Simplified docking
- Live imaging between the steps of the cataract pre-treatment
Liquid and applanating patient interface
Two different interfaces ensure the best possible surgical results and patient comfort.
Tissue Adapted Pulse Management
TAP (Tissue Adapted Pulse Management):
- Laser power adaptation to the tissue
- Lower power in the cornea
- Higher power in the lens
|FEMTO LDV Z8 Less Energy, more Impact: How the FEMTO LDV Z8 is Reforming Laser Surgery
Highlights from Ziemer Opthalmic Systems AG’s Satellite Symposium, held on October 7, 2017, at the XXXV ESCRS Congress.
|FEMTO LDV Z8 Always by your side (CRST Europe Supplement May 2017)
|FEMTO LDV Z8 It’s time to make a move (CRST Europe Supplement Oct 2015)
Content: Femtosecond Laser Surgery – Quo Vadis? (by Prof. Theo Seiler)
Technology of the FEMTO LDV Z8: An Overview (by Prof. Holger Lubatschowski)
Seamless Workflow Integration With the FEMTO LDV Z8 (by Prof. Bojan Pajic)
|FEMTO LDV Z MODELS: An exciting journey into new femtosecond laser technology (CRST supplement Sept 2012)
Content: A Breakthrough in Femtosecond Laser Technology (by Dr. Scott MacRae)
The FEMTO LDV Z Models: Representing the Concept of Swiss Precision (by. Dr. Richard Foulkes)
|FEMTO LDV Z8 – Cataract
Efficient workflow and short learning curve for cataract surgery with FEMTO LDV Z8 FEMTO LDV Z8 – Case study
Ziemer’s Z8 femtosecond laser in case with previous radial keratotomy and tamulosin FEMTO LDV Z Models – Pulse energyCorneal cuts with a nJ-energy femto laser results in less cell death and reduced profibrotic markers FEMTO LDV Z6 – Inverse DSEK
Corneal grafts extracted with the LDV Z6 result in in more precise thickness, minimal cell loss FEMTO LDV – LASIK
Correcting Post-RK Hyperopia with High Frequency, Low Energy FEMTO FEMTO LDV Z Models – LASIK
Low pulse energy flap creation results in significantly less post-op DLK FEMTO LDV Z Models – LASIK Visual recovery
Rapid visual recovery after low energy, thin flap femtosecond LASIK
More Information about Laser Cataract Surgery
For more information regarding this treatment as well as any frequently asked questions, please see below.
Laser cataract surgery uses femtosecond laser technology which incorporates an OCT imaging system that is used to create a detailed 3-D image of the inside of the eye, meaning the surgeon can plan, customise and perform the entire procedure with an unprecedented degree of precision and accuracy. Femtosecond lasers are accurate to within 1/1000th mm.
All laser platforms are designed using a system which requires the patient to position perfectly to t the laser, which presents some challenges for patients as they get older. The Ziemer Z8 is unique in that the laser adapts to the patient’s position, meaning that the experience is comfortable and much easier to achieve success. The other major benefit for the Ziemer Z8 is the laser is the lowest energy laser in the world, using nearly 100 times less energy per pulse to achieve the same outcomes as other lasers. By delivering this low energy nearly 1000 times quicker, the result is a faster, safer and more precise procedure meaning that your vision will recover quicker and with minimal inflammation.
No. The standard lens extraction method is one of the most common surgical procedures in the world today and remains extremely safe. The laser cataract procedure simply brings a new level of repeatable precision for the best chance of optimal vision.
With laser cataract surgery, advanced OCT imaging systems create a live 3-D model of your eye and the data is used to customize treatment to your eye. This makes the procedure extremely precise. The laser is then used to create the incisions, make a perfect central and circular opening to access the lens and soften the lens in a very precise way. In some cases, the use of femtosecond laser technology may also reduce the time it takes to remove your lens. With the standard procedure, the steps are all performed manually.
It is estimated that over 100,000 laser cataract procedures have now been performed with femtosecond laser.
Femtosecond laser technology has been used in LASIK surgery since 2001 and has irreversibly altered the manner in which LASIK surgery is performed around the world. Following advancements in the delivery of this technology, femtosecond laser cataract surgery was given approval in the United States and Europe in 2012, after many years of trials and testing, and has been adopted by many of the world’s leading ophthalmology centres.
Most patients are suitable for this technology, and as part of your initial consultation we undertake thorough diagnostic tests and check the health of your eye to ascertain if you are suitable.
The total laser cataract procedure takes around two minutes followed by the lens being removed by the surgeon and the new artificial lens being placed in your eye. The total time for the laser cataract procedure is roughly 10 minutes
Right at the start there may be some vision, but very quickly this gets very blurry. Vague shapes and movements may be seen, and some patients notice coloured lights.
No. Laser cataract surgery technology was designed with patient comfort in mind. You may experience a little redness to the eye following surgery.
LaserVision was initially founded in Guildford, Surrey. Now with clinics in over 6 locations, we are able to treat the eye conditions of patients nationwide. This treatment is available at: