Optimization of femtosecond lasers using porcine and human donor corneas before in vivo use

• Published in: Journal of cataract and refractive surgery Vol. 44; no. 8; pp. 1018 - 1022
• Main Authors: Stoddard, Jenna E., Marneris, Athanasios G., Borr, Matthew J., Keil, Michael L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2018
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2018.03.035

To demonstrate a safe and effective method of optimizing a femtosecond laser upon installation or for a new procedure before use on patients. In this case, specifically for optimizing settings for intrastromal corneal pocket creation for the presbyopic small-aperture corneal inlay (Kamra) and deep laser in situ keratomileusis (LASIK) flaps for the presbyopic hydrogel corneal inlay (Raindrop). Keil LASIK Vision Center, Grand Rapids, Michigan, USA. Experimental study. Human donor corneas were used to optimize femtosecond laser settings after initial optimization with porcine corneas. The laser used was the Femto LDV Z4. Pocket settings optimized for porcine corneas were 12.0 mm/s pocket and tunnel at 105% energy; whereas, settings optimized with human donor corneas were 13.0 mm/s pocket and tunnel at 110% energy. Settings optimized with human donor corneas were subsequently applied in vivo to create pockets for the small-aperture corneal inlay. Further adjustment of settings to 14.0 mm/s pocket at 110% energy was still necessary to optimize pockets. No change in settings was necessary when creating deeper corneal LASIK flaps (ie, the same settings could be used for flaps of 110 μm or 180 μm). After settings were optimized for porcine corneas, further optimization was necessary before successful corneal incisions could be created in vivo for corneal pockets. No further optimization was required when creating deeper corneal flaps for the hydrogel inlay. It is important to emphasize that settings obtained and reported here are not applicable to other femtosecond lasers.