 All Laser Z-LASIK
Ziemer Femtosecond Laser
The Temecula Refractive Surgery Center is one of the first laser vision correction facilities in California to offer all laser Z-LASIK. We are now using the new Swiss technology Ziemer laser for blade-free LASIK surgery. It is the latest in all laser LASIK design.
LASIK, the most popular and most widely used procedure for vision correction, has been perfected in millions of successful operations over the past 20 years. Now, with Z-LASIK, a technologically advanced system is available to bring top-quality LASIK to our refractive practice.
 Z-LASIK is a LASIK procedure performed with the Ziemer Femtosecond Laser in conjunction with any one of the leading excimer lasers. With the combined use of state-of- the art lasers and diagnostic equipment, Z-LASIK provides the best currently available treatment for superior vision correction.
Z-LASIK is a completely different treatment in fundamental ways. Ziemer's is not just another femtosecond laser, similar to Intralase, Femtec, or Zeiss. Compared to these conventional femtolasers, the Ziemer laser operates at pulse rates that are orders of magnitude higher, pulse energies that are much lower, and delivery optics that are very tightly focused for maximum tissue disruption in the focal spot and no thermal or radiation effects to the surrounding tissue. Unlike other femtolaser-based treatments, Z-LASIK is a highly integrated procedure, giving surgical teams a time-efficient workflow.
Due to its unique hand-held laser delivery system, which is attached to an easily maneuverable articulated arm, patients can be treated on the patient bed of the excimer laser and do not have to be relocated between flap creation and ablation procedures. The surgeon can perform and control the entire procedure from a single working position, without having to move about or changing microscopes. This revolutionary design concept entails several major advantages in clinical practice.
 As the Ziemer laser energy is deployed from a hand piece, which is placed on the patients eye and manually controlled by the surgeon, a procedure results that resembles the operation of a traditional microkeratome. The sterile single-use parts of the hand piece, which are provided in convenient, assorted Procedure Packs, are assembled before the procedure is started and before the patients eye is touched. Similarly, the components are disassembled after the complete (usually bilateral) procedure is completed.
For fixation, the hand piece incorporates a vacuum suction ring, which is available for a range of flap diameters from 8.5 to 10mm. The ring is mounted over the applanation window on the underside of the hand piece. Positioning applanation, and suction are controlled visually through the hand piece observation window and the excimer laser's microscope.
 A novel, proprietary laser cutting process developed specifically for Ziemer’s system provides for effortless, gentle tissue separation with minimal tissue bridges. The process generates minuscule bubbles that help visualize the flap edge for easy opening. The bubbles disintegrate instantly when the flap is lifted. Consequently, the excimer laser ablation process may be initiated immediately after completion of the flap creation process, saving process time and minimizing exposure of stroma.
The process creates a smooth edge with approximately 45-degree angulation. This edge geometry, which resembles edges created with mechanical microkeratomes, ensures a tight, dynamic fit of the flap into the incision, and helps avoid epithelial ingrowth.
Flap dimensions are computer controlled and are set through an intuitive set of parameters via a user-friendly graphical user interface and touch-screen. Hinge position, hinge angle and width, flap diameter, and flap thickness can be selected by the surgeon to create a customized flap optimized to bulbus dimensions and surgical requirements. There are no parts moving on the cornea; hence less trauma to the epithelium than with mechanical microkeratomes.
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