Laser-assisted in situ keratomileusis flap creation with the three-dimensional, transportable Ziemer FEMTO LDV model Z6 I femtosecond laser

Abstract

Purpose: To present the outcomes of laser-assisted in situ keratomileusis (LASIK) operations performed with the new three-dimensional, transportable FEMTO LDV Z6 I femtosecond laser (Ziemer Ophthalmic Systems, Port, Switzerland) and the Allegretto Wave Concerto 500 Hz excimer laser (Wavelight AG, Erlangen, Germany) in terms of accuracy, reproducibility and safety of flap creation.

Methods: This is a retrospective study of 309 consecutive eyes of 160 patients treated with the FEMTO LDV Z6 I for corneal flap creation. The target flap thickness was 90 μm. The size of the suction ring varied from 9.5 to 10.0 mm and target flap diameter from 9.3 to 9.6 mm, respectively. The target hinge length was 4.0 mm.

Results: The FEMTO LDV Z6 I produced the 90-μm targeted flaps very consistently (mean 90.1 ± 2.7 μm, range 78-100). Mean flap diameter with the 9.3-mm target flap diameter was 9.3 ± 0.1 mm (range 9.0-9.6) and with the 9.6-mm target flap diameter 9.6 ± 0.1 mm (range 9.0-9.8). Mean hinge length was 3.9 ± 0.1 mm (range 3.3-4.2). Minor complications were reported in 15 (5%) eyes, but none of them prevented refractive laser treatment. The most common complications were bubbles in the conjunctiva (n = 7, 2%) and an opaque bubble layer inside the flap margin (n = 6, 2%). None of the eyes lost two Snellen lines of corrected distance visual acuity during 1-month follow-up.

Conclusions: In the hands of an experienced surgeon, the transfer from the Classic FEMTO LDV to Z6 I was a safe and straight forward process yielding accurate and reproducible flaps.

Keywords: femtosecond laser; flap creation; flap thickness; laser-assisted in situ keratomileusis.