Femtodynamics: Optimizing Femtosecond Laser Settings and Procedure Techniques to Optimize Outcomes

Abstract

Femtosecond lasers reinvigorated laser-assisted in situ keratomileusis (LASIK), simplified insertion of Intacs, and reinvented corneal transplantation. They have brought precision to corneal surgery just as phacoemulsification brought precision to lens surgery. And just as with phacoemulsification, surgery with femtosecond lasers presents a unique set of challenges, requiring mastering the knowledge of laser-tissue interaction, understanding and adjusting laser settings to ensure easy and uneventful surgery, and developing procedure techniques to optimize the outcomes. The concept of femtodynamics for corneal surgery is inspired by the concept of phacodynamics for lens surgery. Phacodynamics is a system of optimizing phacomachine settings (vacuum, ultrasound energy, flow, etc.) and techniques of manipulating the lens to ensure quick and successful cataract removal. Femtodynamics is a system of optimizing femtosecond laser settings (spot-size separation, energy, side cut specification, etc.) and procedure techniques to create consistent and predictable corneal resection with minimal effect on the surrounding tissue regardless of corneal shape, size, and other patient-specific factors.