Ziemer Advances in

Femtosecond Corneal
Surgery
Scott MacRae MD.
University of Rochester
Flaum Eye Institute

FEMTO LDV Z Models

FEMTO LDV Z2
Handpiece:
MkII-Handpiece = xy (planar)
resections
Applications standard:
Z-LASIK (Classic and Crystal
resection methods)
Available options:
n/a
3

FEMTO LDV Z4
Handpiece:
Z-Handpiece = xyz resections
Applications standard:
Z-LASIK full capability (Classic,
Crystal and with vertical cut)
Available options:
Intracorneal rings
Intrastromal pockets
4

FEMTO LDV Z6
Handpiece:
Z-Handpiece = xyz resections
Applications standard:
Z-LASIK full capability (Classic,
Crystal and with vertical cut)
Intracorneal rings
Intrastromal pockets
Available options:
Lamellar Keratoplasty
Penetrating Keratoplasty
5

(1/2)

FEMTO LDV Z6

(2/2)

The corneal applications are constantly being developed

as we continue to learn:
Limbal relaxing incisions
Arcuate incisions
Lamellar preparation for treatment of
corneal blindness
Biomechanically enhanced procedures

Designed for future applications:

Designed for OCT System

Designed for Cataract Surgery

FEMTO LDV Z Models

Z-LASIK the gold standard
Flap thickness:
Z2 90, 100, 110, 140 um
Z4 & Z6 any (90 160 um)

Flap diameter:
Z2 8.5, 9.0, 9.5, 10.0 um
Z4 & Z6 any (6.5 10 mm)

Classic and Crystal trajectories

Z2

Z4

Z6

FEMTO LDV Z Models

Z-LASIK Z NEW!
Resection in three dimensional mode (xyz)
Any flap thickness (90 160 um)
Any flap diameter ( 6.5 10 mm)
Customizable flaps to accommodate
the desired geometry:
Round and oval flaps
Angled edge as desired by surgeon
Fully-adjustable hinge size and position
Z2

Z4

Z6

LDV General Observations

Microbubble technique minimizes tissue
reaction
Minimizes Inflammation
OBL, TLS, DLK
Minimal Cavitation
more finely focused bubble layers
makes breakthrough very unlikely
(Safer) very important
Highly reliable no amplifiers

Observations
Microbubble technique minimizes tissue
reaction:
Allows Rx over scars Dr. Tomita
Retreats: relifts easy with 90,100,110
micron flaps
Acts more like very fine tipped pen than a
sharpie

Z6 Observations
X-Y Adjustment for Centration is Great
Steeper side cuts gives very precise
repositioning alignment
No gap between flap & stromal bed
Less discomfort
Quicker visual and neurotrophic
recovery
Very quiet flaps 1 day PO

MacRae, S.M.: Excimer

Ablation Design and
Elliptical Transition
Zones. JCRS, 25:11911197, 1999

MacRae, S.M.: Excimer Ablation Design and

Elliptical Transition
Zones. JCRS, 25:1191-1197, 1999

30 Micron 6mm X 9mm Flap

14

Thank You