LASIK, and its advanced form, Femto-LASIK is by far the most widely performed procedure in the world today. Femtosecond Lasers were first introduced for clinical use in late 2000 to ensure more safety and predictability with creation of high-precision flaps, efficient patient management and the best possible results.Except creation of flap with the femtosecond laser the other steps of the procedure are same as conventional LASIK.

What is Femto-LASIK:
Femto-LASIK is a ‘bladeless procedure’ where only femotsecond laser is used to cut the flap. It is thus a more precise, predictable and safe method for creating the corneal flap as compared to the conventional microkeratome(‘blade’) flaps. After creation of a Femto-Flap the surgeon then shifts the patient to an excimer laser for correction of refractive errors.
Advantages of Femto- Flap Lasik with VisuMax
The VisuMax Femtosecond is extremely fast; operating at 500 KHz which delivers very smooth flaps that surgeon can lift easily without creating trauma to the eye.


  • High-precision flaps due to high-performance femtosecond technology.
  • Highly predictable and accurate flap thickness (80 µm – 220 µm) and dimension.
  • One-step docking procedure.
  • Low suction pressure and minimal IOP increase.
  • No vision loss during suction.
  • Easy repositioning of the flap
  • Smooth stromal bed surfaces
  • Suction is only applied during actual laser procedure
  • Fully automated force control during eye docking
  • Each CG is calibrated in process
  • Minimum discomfort for the patient
  • US FDA Approved
Who is eligible for Femto-Lasik?
To have the Femto Lasik procedure, you must:

• Be 18 years of age or older;
• Have healthy eyes free from retinal problems, corneal scars, and any eye disease;
• Have stable vision prescription for the last 6 months
• Be able to lie flat without difficulty;
• Be able to look directly at a blinking light during the whole procedure;
• Be willing to sign an Informed Consent Form provided by your doctor;
• Be able to tolerate eye drops to numb your eye.

Laser vision correction is not advised for pregnant or lactating mothers.
The following powers can be corrected after creation of Femto Flap.
Examination and Counseling before Femto-Lasik
As with other Laser Vision Correction methods, you will first need to undergo a detailed eye examination to determine whether you are a suitable candidate.

Many factors play a role, including the nature and degree of the refractive error, the curvature and thickness of the cornea. Your profession and hobbies are also important. Your eye doctor will be happy to assist you in finding the best option for your vision needs.

Take your eye prescription records with you to the exams. Your doctor will

• Dilate your pupils to fine-tune your prescription
• Examine your eyes to make sure they’re healthy. This includes a glaucoma test and a retina exam
• Take the following measurements:

a) The curvature of your cornea and the size of your pupils
b) The topography of your eyes to make sure you do not have an irregular astigmatism or a cone-shaped cornea — a condition called Keratoconus
c) The pachymetry — or thickness of your cornea. You need to have enough tissue left after your corneas have been reshaped

Before coming for the tests a contact lens wearer must stop wearing lenses at least for one week earlier.

If it is determined that you are not a good candidate for Femto-Lasik surgery:

• You will be given an explanation as to the reasons why you are not a good candidate.
• You may want to consider an alternative method of refractive surgery, or stay with your glasses or contact lenses for the time being.
How do I prepare for Femto Lasik?
If you wear contact lenses, most surgeons recommend switching to glasses a few weeks before surgery. You are advised not to apply makeup, lotions or perfume the day you have surgery. Also, it is suggested that you arrange to have someone bring you home afterward.

Consent:
You will be asked to sign an informed consent form after a thorough discussion of the risks, benefits, alternative options and possible complications.

How Femto-LASIK is done:
Femto-LASIK surgery is a two- step surgical procedure and is done with the combination of VisuMax and MEL-90 laser systems from Carl Zeiss, Germany.

Preparation:

  • On the actual day of surgery, you will be given some numbing drops in your eye(s).
  • Upon entering the surgery room, you will be asked to lie down on the swiveling laser bed.
  • Anesthetic eye drops are applied to the eye.
  • An eyelid holder is used to prevent the eye from blinking during the procedure.
  • The eye not having surgery may be covered with a temporary shield.
  • The laser system uses a disposable, single-use Treatment Pack that will be attached to your cornea by light suction on the eye but you will be able to see the blinking light and your doctor will ask you to keep looking right at a blinking light.
  • The light will be visible throughout the entire procedure, though at times it could get slightly blurry.
  • Your doctor will guide you to follow the steps. You will hear a voice instruction (Suction-On) and at this point you have to be calm and quiet because the actual laser is about to start now to create the corneal flap.
  • After making the flap with the femtosecond laser you will be the shifted to the MEL-90 excimer laser system with the swiveling bed for actual power correction.
  • At this point, the excimer laser is used for the corneal ablation to correct the nearsightedness, farsightedness/or astigmatism.
  • When the ablation is completed, the flap is folded back and the operation is over.
  • The operation does not involve any injection, stitch, bandage etc.

What happens after surgery?
After the surgery, your doctor will put some medication drops into your eye.

The nursing staff will take you to a recovery room where you will take rest for around 15 minutes.

Your doctor will examine your eyes with a Slit-Lamp

After a brief instruction about medications you will be discharged from the clinic.

Your eye may experience some discomfort. If necessary, your doctor may prescribe oral pain medicine for use as necessary.

You may be mildly sensitive to light and glare. Wear sunglasses to ease your discomfort. You may also have the feeling that something is in your eye. Do not rub your eye if you feel this sensation.

Your vision probably will be blurry the day of surgery, but it will improve considerably by the next day when you return for a follow-up exam.

Use all medication eye drops and lubricants your doctor prescribes as directed. These are necessary for the proper healing of your eye(s).

We recommend our patients to remain at home for the first one or two days following the surgery to avoid dust while they can perform their daily routine like reading, watching TV, Computer work etc. from next day.

Contact sports should also be avoided for several weeks.

During the first 1-2 months your vision will fluctuate before finally stabilizing. Some dry eye may occur and your doctor can give you eye drops to counteract the dry eye. This is because your tear ducts may not be able to compensate for the new shape of your eye, so it does not produce enough moisture to keep the eye comfortable. You should contact your doctor at the first sign of irritation or blurred vision. The best advice is to follow everything your doctor says. If you can make it through the first six months with no problems, chances are your eyes will do fine from then on.

If you experience aggravating or unusual side effects, report them to your doctor immediately.

It is customary to have a post-op examination the next day. Further examinations are usually scheduled for the following weeks or months. It is important for you to keep these appointments to monitor your healing process.

Steps of the Femto-Flap Lasik:
STEP 1 - Creating the flap. A flap is created with a highly precise femtosecond laser.
STEP 2 - Relocating the patient . The patient is conveniently moved from the femtosecond laser to the excimer laser.
STEP 3 - Folding back the flap.
The flap is gently folded back, exposing the inner corneal tissue to be treated.
STEP 4 - Correcting the error.
An excimer laser reshapes the corneal tissue, correcting the refractive error.
STEP 5 - Repositioning the flap.
The flap is returned to its original position, protecting the eye like a natural bandage.

Do’s
  • Go home with a driver or someone to escort you.
  • Sleep for several hours, your eyes need rest
  • Carefully follow all the instructions given by your doctor.

Don’ts
  • Go into smoky or dusty surroundings for some days
  • Indulge in hot showers or swimming activities till instructed
  • Rub or itch your eyes unnecessarily
  • Wear eye make up for 2-3 weeks