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Femto platform offers safe, accurate flap creation, early adopter says
The LenSx platform, newly approved for flap creation in laser refractive surgery, enables surgeons to customize flap design.
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Surgeons who use the LenSx femtosecond laser for cataract surgery are now able to use the platform for flap creation in laser refractive surgery. The U.S. Food and Drug Administration approved the LenSx for creating corneal flaps in October.
The LenSx platform (Alcon) is well-suited to flap creation, Zoltan Z. Nagy, MD, OSN Europe Edition Board Member, said in an email interview.
“I use the LenSx femtosecond laser for flap creation. I have been using it since last December and I like it very much. It is a quick and reliable procedure,” Nagy said.
Nagy has more than 4 years’ experience using the LenSx laser for cataract surgery.
“I have been using the same femtosecond laser for cataract surgery for capsulotomy, lens fragmentation, liquefaction and creation of corneal wounds,” he said. “Moreover, I was the first who used the femtosecond laser in cataract surgery in August 2008, so this is the fourth anniversary for me.”
Zoltan Z. Nagy
The LenSx platform is approved by the FDA and has CE mark approval in Europe for capsulotomy, lens fragmentation and corneal incisions for cataract surgery.
Accuracy and flexibility
The LenSx laser offers many benefits in terms of ease of use and flexibility, Nagy said.
“The best aspect [is] that we can use the same femtosecond laser and the same patient interface for cataract and refractive purposes. The procedure is easy and quick, similar to other corneal femtosecond lasers, which cannot be used in cataract surgery,” he said. “The corneal bed is even and it is easy to open.”
Nagy and colleagues are currently undertaking a study on use of the LenSx platform to create corneal flaps.
So far, the LenSx has enabled surgeons to create accurate, customizable flap designs, Nagy said.
“The exactness of the flap is under evaluation,” he said. “At the moment, I can tell you that after a proper [patient interface] insertion, the flap design is very good. I prefer the 70° angle cut with a superior hinge, but the surgeon can customize all steps of the procedure. It seems that the achieved flap thickness correlates very well with the attempted ones. Results seem to be far better compared to mechanical microkeratomes.”
Rapid visual recovery
Flaps created with the LenSx self-seal and heal faster than microkeratome-created flaps, Nagy said. Furthermore, LenSx flaps afford rapid visual recovery, he said.
“After the surgeon positions back the flap and removes the fluid from the cut area, the flap adheres,” he said. “Most of my patients achieved full visual acuity for the next day, so I was very content with the results. I had no [diffuse lamellar keratitis] or any other infection. Sterility, of course, is an important issue whatever method is used for flap creation.”
Nagy said he expects surgeons already using the LenSx for cataract surgery to make a seamless transition to using the platform for flap creation.
“It is an important issue, because cataract and refractive surgery seem to merge in the near future, and it is important to have a proper device to help both in cataract and refractive surgery. As far as I know, surgeons are awaiting the corneal program of the femtosecond laser,” Nagy said. – by Matt Hasson