Damien Gatinel Fondation Rothschild C.E.R.O.C

Paris, France

ALCON WAVELIGHT

FS200 FEMTOSECOND LASER

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ROTHSCHILD FOUNDATION - PARIS

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Refractive Suite

FS200 LASER FS200 LASER

ALCON WAVELIGHT FS 200

Improved ergonomics Clever aplanation

Faster flap creation Large(r) Flaps

Larger (re)centered Flaps Customized Flaps Smooth interface

Less OBL Less Sub conj Hemorragae Better network integration

200 KhZ - 350 fs - 1microJ/p

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1st movable joystick : cone shifting / docking

OD OS

ERGONOMICS

2nd Joystick : bed / head positionning

WaveLight® FS200: “The fastest Femtosecond laser”

Shortest time (minimum duration = 6 seconds (≈ 8 mm flap)

FASTEST FEMTO- LASER

FLAT APLANATION /

RASTER PULSE PATTERN

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DAILY SUCCION / ENERGY calibration

PRECISION CONTROL

Beam Control Check: each cone is calibrated before use

9

line separation

spot separation

Hinge width

SPOTS / LINE SEPARATION

≈1 Million spots for flap φ= 9 mm

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SUCCION CONE

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BCC = Beam Control Check Calibration : each procedure

Compensation for local &“hardware” fluctuations

BCC = Beam Control Check

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ERGONOMICS

DOCKING system

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Lunar & Command Module Docking

FS 200 laser : app. cone and cone docking

APOLLO 11 : « Docking »

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DOUBLE SUCCION

CREATION OF A CANAL BETTER EYE TRACKING BETTER INTERFACE HOMOGENEITY EASIER INTERFACE CREATION

CORNEAL TISSUE

Stroma (flap)

Gaz bubble

OBL (OPAQUE BUBBLE LAYER) PREVENTION

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DOCUMENTATION / OUTPUT

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Available FS treatments :

Sub-Bowman Keratomileusis

Full and partial thickness trephinations

Intracorneal ring segments

Pockets creation (KAMRA/ Acufocus – inlays)

18 For Internal Use Only

VERSATILITY

20 mm

18 mm

13 mm

11 mm

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ALCON / WL

INTRALASE

LARGER APLANATION

WINDOW BUT:…

... SMALLER RING DIAMETER !

TOTAL APLANATION WINDOW: 13 mm

FLAP DIMENSIONS

ADJUSTABLE Centration WITHIN 11 mm ZONE

TRANSLATION : no cropping = no diameter reduction

11 mm

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11 mm

FLAP DIMENSIONS / CENTERING

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11 mm

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FLAP DIMENSIONS / CENTERING

CUSTOM FLAP

- Flap dimension : up to 10mm ! (13 mm aplanation)

- Flap hinge : adjustable position (0° à 360°)

- Flap perimeter: elliptical

FLAP CUSTOMIZATION

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FLAP CUSTOMIZATION: HINGE LOCATION

OVAL FLAP 9.5x 8.5 mm / OBLIQUE HINGE

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COSMECTIC ASPECT AT DAY 1 :

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The fixation ring uses peripheral spacers to minimize sclera deformation :

- Less IOP rise (60/100 mmHg)

- Less sub conjonctival hemmoraege

Laser Femtoseconde FS200

Laser Excimer EX500 CUSTOM FLAPS : ELLIPTICAL / HINGE POSITION

- Efficient Spots

- Optimisation of interface dimensions

BETTER INTEGRATION OF THE

ABLATION PROFILE

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CIRCULAR FLAP CUSTOM ELLIPTICAL FLAP

9.5 x 8 mm Hinge positioned

along steep axis D Gatinel

… …

CUSTOM ELLIPTICAL FLAP

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CUSTOMIZING FLAPS

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CUSTOM ELLIPTICAL FLAP 9.5 x 8.2 mm A.T.R MYOPIC ASTIGMATISM : -3 (-1.50x80°) TEMPORAL HINGE

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TEMPORAL NASAL

CUSTOM ELLIPTICAL FLAP: 9.5 x 8.5 mm Mixed / Hyperopic Astigmatism +0.75 (-1.75 x 140°) OBLIQUE HINGE

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FS 200 FEMTOSECOND LASER

More reproducible and ergonomic aplation Faster flap creation

Large(r) Flaps Custom plaps

Larger (re)centered Flaps Less OBL

Smoother interface Less sub conj. hemorragae

Versatility Network integration

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THANK YOU !

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