Femtosecond laser can create customized intracorneal ring segment tunnels

ROME — The Ziemer femtosecond LDV laser has the capability of creating precisely customized tunnels for the insertion of intracorneal ring segments, according to one surgeon here.

"The new deep-cutting handpiece with integrated camera, specially designed for this purpose, allows the surgeon to create the tunnels easily and reproducibly. In addition, thanks to a new special software, the tunnels can be precisely adapted to ring geometry and size," Maria Clara Arbelaez, MD, said at the winter meting of the European Society of Cataract and Refractive Surgeons.

Because every keratoconus case is different, the treatment with intracorneal rings might require an individualized asymmetric implantation of Intacs (Addition Technology) with different thicknesses or Kerarings (Mediphacos) with different arc lengths. The new software allows the creation of individual tunnel patterns, adapted and optimized to the ring length and thickness.

Dr. Arbelaez has treated 37 eyes with keratoconus at various stages with either Intacs or Kerarings using the LDV laser.

"At day 1, all eyes were quiet with clear corneas and perfectly positioned rings. The 1-month data of the Intacs series showed an improvement of UCVA in all eyes with a gain of more than four lines in 66% of the cases," she said. "One incomplete cut due to the small applanation area was easily and successfully redone, thanks to the precise positioning capability of the laser. All other tunnels were performed in the intended position at intended depth. The ring position remained unchanged throughout the follow-up."