The VisuMax Femtosecond System offers surgeons another option for bladeless flap creation.
The VisuMax Femtosecond System (Carl Zeiss Meditec) is the third femtosecond laser to hit the US market. Like the IntraLase™ (AMO), the VisuMax system offers benefits over a manual microkeratome, including more accurate flap thickness, greater control over flap diameter and hinge position, and reduced risk of flap-related complications. The unique design of the VisuMax system also makes the instrument efficient for surgeons and reduces patient anxiety.
The VisuMax system integrates the process of affixing the laser to the eye, making it a quick, one-step process. I find that I can easily treat 8 to 10 eyes per hour. Because the cornea does not have to be applanated with the VisuMax system, the flap can be created with less suction. This means a much smaller rise in intraocular pressure, which reduces the risk of inducing a visual field defect. Additionally, patients can see the fixation light throughout the entire flap-making process. The lack of “blackout” is appealing because it may reduce patient anxiety. Finally, because suction is only applied to the cornea, the VisuMax system rarely causes conjunctival hemorrhages.
In addition to the integrated suction system, other benefits of the VisuMax system include the use of lower pulse energy (170-200 nJ per pulse), which reduces the risk of inflammatory reaction. Flap thickness is highly predictable with the VisuMax system, which, like the IntraLase, offers much greater predictability than mechanical microkeratomes. The VisuMax system’s spiral shot pattern, which uses an out-to-in movement, avoids the creation of an opaque bubble layer. Finally, the VisuMax system allows surgeons to customize the radial spacing, linear spacing, and energy of the laser spots.
Because of these design innovations, the VisuMax system has plenty to offer surgeons, regardless of the excimer laser they use. However, using the VisuMax system in concert with the Carl Zeiss Meditec MEL 80 excimer laser confers some additional benefits: each piece of equipment can transfer patient data to the other’s computer, and the patient bed is designed to swing between the two machines.
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