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P. S. Binder; New Femtosecond Laser Software Technology to Create Intrastromal Pockets for Corneal Inlays. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2868.
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To develop a safe and repeatable procedure to allow implantation of intracorneal implants.
New software (Abbott Medical Optics, Santa Ana, CA) with the 150 kHz iFS laser in human eye bank eyes creates pockets up to 400 microns deep in diameters up to 9.2 millimeters. The entrance site can be placed nasally or temporally; the width of the entrance can be in millimeters. The side-cut angle can be 30° - 90°. Intrastromal ablation is also possible. The optics can be decentered and the dimensions of the tunnel and optical center can be adjusted with software.
Initial Acufocus presbyopic inlays were implanted under a 150 um mechanical LASIK flap in 150 cadaver eyes and later under a "flocket" (intrastromal femtosecond laser and 30 degree side cut) in 20 cadaver eyes. Subsequently a keyhole shape infrared blocker was placed within the glass cone to outline an area that would not be dissected by the raster pattern leaving a tunnel from the optical center to the corneal periphery. Thenew procedure takes less than 20 seconds with easy access to the interface through the peripheral wound. A 0.5 mm oversize optical zone permits adjustment of inlay centration. No sutures are required.
This software allows the surgeon total control of all pocket dimensions for either implantation of inlays or rings of any dimensions, but it also permits injection of Riboflavin for collagen crosslinking procedures. Concurrent intrastromal ablation can also provide additional fixation of an implant that because of its thickness would normally increase corneal curvature negating a presbyopic correction.
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