Comparative study supports use of femtosecond laser for inserts channel creation

Chicago-Implantation of micro-thin prescription inserts (Intacs, Addition Technology) in eyes with keratoconus appears to result in better refractive and visual outcomes when the femtosecond laser (IntraLase FS, IntraLase) is used for channel creation instead of a mechanical device, said Yaron Rabinowitz, MD, at the refractive surgery subspecialty day meeting sponsored by the International Society of Refractive Surgery of the American Academy of Ophthalmology.

Dr. Rabinowitz compared results from 6 months of follow-up in a group of 20 eyes that underwent surgery using the femtosecond laser for channel creation with 1-year data from a series of 10 eyes that had the channels created with a mechanical spreader. There was a slight advantage for the mechanical device group versus the femtosecond laser group for greater reduction in average K readings, 2.51 versus 2.37 D.

However, mean SE improved by 3.27 D in the femtosecond laser group versus only 2.57 D in the mechanical device group, uncorrected visual acuity improved 3.72 lines in the femtosecond laser group compared with 3.6 lines in the mechanical device group, and most dramatically, best-corrected visual acuity improved by 3.54 lines in eyes with femtosecond laser-created channels versus a gain of 1.75 lines in the mechanical device group. At 6 months, 85% of the patients were contact lens- or glasses-tolerant in the femtosecond laser group versus 70% in the mechanical group.

 “Certainty of depth of placement is a big advantage using the femtosecond laser and it is also very friendly to the patients and surgeon. Now, further follow-up is needed to determine how the outcomes of the femtosecond laser procedure compare at 12 months with the mechanical technique,” said Dr. Rabinowitz, director of ophthalmology research, Cedars Sinai Medical Center, Los Angeles.