Scanning Electron Microscopy Evaluation of Scanning Electron Microscopy Evaluation of Corneal Residual Beds Created by a 5Corneal Residual Beds Created by a 5thth

Generation of Femtosecond LaserGeneration of Femtosecond Laser

Helga P. Sandoval, M.D., M.S.C.R., Helga P. Sandoval, M.D., M.S.C.R., Mohamed A. Guenena, M.D., Kerry D. Mohamed A. Guenena, M.D., Kerry D. Solomon, M.D.Solomon, M.D.

Magill Research Center - Storm Eye InstituteMagill Research Center - Storm Eye InstituteMedical University of South CarolinaMedical University of South Carolina

Charleston, South Carolina, USACharleston, South Carolina, USAFinancial Disclosure: Financial Disclosure: None of the authors has any financial interest in any product mentioned hereinNone of the authors has any financial interest in any product mentioned hereinHelga P. Sandoval: Alcon Laboratories, Inc. - D; Allergan, Inc. - D; Abbott Medical Optics - DHelga P. Sandoval: Alcon Laboratories, Inc. - D; Allergan, Inc. - D; Abbott Medical Optics - DMohamed A. Guenena: NoneMohamed A. Guenena: NoneKerry D. Solomon: Alcon Laboratories, Inc. - A,C,D; Allergan, Inc. - A,C,D; Abbott Medical Optics - A,C,D; Advanced Vision Research - A,C,D; Kerry D. Solomon: Alcon Laboratories, Inc. - A,C,D; Allergan, Inc. - A,C,D; Abbott Medical Optics - A,C,D; Advanced Vision Research - A,C,D; Bausch & Lomb, Inc. - A,C,D; Eyemaginations - A,C,D; QLT, Inc. - A,C,D Bausch & Lomb, Inc. - A,C,D; Eyemaginations - A,C,D; QLT, Inc. - A,C,D

Helga P. Sandoval, MD, MSCR

55thth Generation Femtosecond Laser Generation Femtosecond Laser

• Higher repetition rate– Tighter spot separation– Faster procedure time– Lower energy

• Customized flap shapes• Expanded bevel-in side cut angles

Helga P. Sandoval, MD, MSCR

5th Generation Femtosecond Laser5th Generation Femtosecond Laser

Helga P. Sandoval, MD, MSCR

PurposePurpose

• To evaluate the smoothness of the corneal residual bed after the flap creation using a 5th generation femtosecond laser (iFS Advanced Femtosecond Laser, Abbott Medical Optics, Inc)

Helga P. Sandoval, MD, MSCR

Methods Methods

• 5 fresh cadaver eyes, tissue not suitable for transplantation

• 5th generation femtosecond laser settings:

EyeEyeFlap Flap

thicknessthickness

Flap Flap

diameterdiameter

Hinge Hinge

positionposition

Hinge Hinge

AngleAngle

Side cut Side cut

energyenergy

Side cut Side cut

angleangleOversizeOversize

1 OD1 OD 110110 8.58.5 NasalNasal 4545 0.620.62 7070 00

1 OS1 OS 110110 8.58.5 NasalNasal 4545 0.620.62 7070 00

2 OD2 OD 110110 8.58.5 NasalNasal 4545 0.620.62 7070 1212

2 OS2 OS 110110 8.58.5 NasalNasal 4545 0.620.62 150150 1212

3 OD3 OD 110110 7.97.9 NasalNasal 4545 0.620.62 150150 1212

Helga P. Sandoval, MD, MSCR

Methods Methods

• Flap and residual bed were fixed using 2% cacodylate glutaraldehyde and processed for SEM evaluation.

• The residual bed surfaces as well as the posterior face of the flap and edges were examined.

• Standardized photographs were taken.

Helga P. Sandoval, MD, MSCR

ResultsResults

• Mean donor age was 78.3 ±10.7 years

• Mean time from dead to preservation was 10:31 ±5:37 hours

• No complications during flap creation

Helga P. Sandoval, MD, MSCR

ResultsResults

SEM picture of eye 1OD

Helga P. Sandoval, MD, MSCR

ResultsResults

SEM picture of eye 2 OS

Helga P. Sandoval, MD, MSCR

ConclusionConclusion

• New 5th generation femtosecond laser provides smoother residual bed than previous version. This may translate into:– Better visual outcomes– Less induction of high order aberrations– Higher patient satisfaction– Further clinical studies are necessary.