Creating corneal inlay pockets with femtosecond laser technology

Reviewed by Majid Moshirfar, MD

Salt Lake City-Using a femtosecond laser to create the proper pocket in the correct position to allow the precise placement of a small-aperture corneal inlay (Kamra, AcuFocus) for optimal vision correction requires finesse and expertise.

“We have three different platforms that can create pockets for the inlay and they can all do an excellent job in experienced hands,” said Majid Moshirfar, MD.

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“I personally use the Intralase iFS and the Alcon FS200 to create pockets and I can’t find a difference between them in performance,” said Dr. Moshirfar, clinical professor of ophthalmology, University of Utah Moran Eye Center and medical research director, Hoopes Vision, Salt Lake City.

But the Intralase  iFS, Alcon FS200 and Ziemer FEMTO LDV Z8 are not identical. The iFS was the first femtosecond laser on the U.S. market, Dr. Moshirfar said.

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U.S. surgeons have more experience on the iFS than any other platform and have devoted more time and attention to tweaking and calibrating its operational parameters.

“The limitation with this device is that it can only create a pocket along the temporal aspect of the cornea,” he added. “That can be a limitation when you have a patient who could be better treated with an incision from another direction.”

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The FS200 and the Z8 have their own advantages and limitations. Both can create pockets at any angle.

The Z8 creates wider pockets than the other two platforms, which gives more space for instrumentation and maneuvering while placing the inlay. Docking is very easy and the device gives the familiar feel of microkeratome. The FS200 is quick and easy to operate and allows the operator to trace the path of the incision for more precise placement.

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