Ziemer Ophthalmic Systems AG
Tailor-made keratoplasties ranging from penetrating to ultra-thin lamellar grafts.

Keratoplasties

Femtosecond laser-assisted keratoplasty surgery.

Using low energy in each laser pulse in the nanojoule range, the FEMTO models are the ideal tools for tailor-made keratoplasties ranging from penetrating to ultra-thin lamellar grafts or the new liquid penetrating keratoplasties on the FEMTO Z8.

The Z8 and Z6 femtosecond lasers allow for patterns and angles of incisions that are not achievable with conventional trephines. With the use of proprietary software, the newer shapes of wound construction have been associated with better wound integrity, presumed faster donor-recipient junction wound healing, earlier suture removal, less surgically induced corneal astigmatism, and earlier visual rehabilitation.1

Benefits at a glance

  • OCT imaging enables to detect scars and other corneal abnormalities
  • Big Bubble technique made easy with the DALK module2
  • Choose between lamellar and penetrating keratoplasties
  • NEW: Arcuate resection module to create customized crescent shapes within the cornea
  • Liquid penetrating keratoplasty prevents corneal applanation
  • Wide range of settings possible for customized surgery (e.g. rotating keratoplasty)
  • Proprietary artificial anterior chamber for donor preparation in a sterile environment
The FEMTO models offers multiple applications that can be customized for your surgical needs and it grows as your practice and technology advances.

OCT guided Keratoplasties

  • OCT-guided keratoplasty surgery is unique to the Z8 models
  • With the intraoperative OCT imaging, the Z8 enables the physician to detect scars and other corneal abnormalities. It also allows the physician to check the applanation area and corneal structures in general
  • The treatment plan can be adjusted and customized intraoperatively on the OCT to best fit the patient's cornea
OCT visualization - The FEMTO model’s integrated OCT enables for intraoperative visualization and a new level of customization in keratoplasty surgery. An example is the placement of a guiding tunnel close to the Descemet’s membrane for the big bubble-technique, which you can follow with the canula.

DALK, DSEK and UT-DSEK

  • Choose between different ultra-thin lamellar keratoplasties (DALK, DSEK, UT-DSEK) and penetrating keratoplasties (mushroom, top-hat, straight)
  • The grafts are customizable to each patient through resection depth, shape, side-cut geometries, and angles
  • The proprietary artificial anterior chamber enables an ideal graft preparation for best alignment of donor to recipient interface
Choose between different ultra-thin lamellar Keratoplasties (DALK, DSEK, UT-DSEK) and penetrating Keratoplasties (mushroom, top-hat, straight).

Arcuate Resection

  • NEW: The Arcuate Resection module on the FEMTO Z8 allows the creation of customized crescent shapes within the cornea
  • A clinical application of these cuts can be found as a step in the corneal remodeling procedure of Dr. César Carriazo, which aims to flatten the ectatic cornea by means of a crescent keratectomy3
Arcuate resection - the arcuate resection module on the FEMTO Z8 allows the creation of customized crescent shapes within the cornea.

Liquid penetrating Keratoplasty

  • The new liquid penetrating keratoplasty application on the FEMTO Z8 preserves the natural corneal curvature during the laser trephination process
  • Using the liquid patient interface, any mechanical deformation of the corneal tissue is avoided during trephination
  • The side-cut geometries improve the alignment of the donor and recipient interface, potentially leading to less astigmatism and better wound adaptation at this step of surgery, even in cases of advanced keratoconus
Liquid penetrating keratoplasty with the FEMTO LDV Z8
Liquid penetrating keratoplasty - The new liquid penetrating keratoplasty application on the FEMTO Z8 preserves the natural corneal curvature during the laser trephination process.

More Applications

Videos

Arcuate incisions with the FEMTO LDV Z8 by Prof. Rupert Menapace. Watch a step-by-step video tutorial about FLACS with arcuate incisions for corneal astigmatism correction.
Videos

Arcuate incisions with the FEMTO Z8

Prof. Rupert Menapace

Prof. Gerald Schmidinger (AKH Vienna, Austria) performs "liquid penetrating keratoplasty" with the Ziemer FEMTO LDV Z8 femtosecond laser.
Videos

Liquid penetrating keratoplasty with the FEMTO LDV Z8

Prof. G. Schmidinger

Inserts and Supplements

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[1] Shivanna Y, Nagaraja H, Kugar T, Shetty R. Femtosecond laser enabled keratoplasty for advanced keratoconus. Indian J Ophthalmol. 2013 Aug;61(8):469-72. doi: 10.4103/0301-4738.116060. PMID: 23925340; PMCID: PMC3775090.

[2] https://crstodayeurope.com/wp-content/uploads/sites/5/2018/08/CRSTE_0918Ziemer_Mehta.pdf

[3] Carriazo, César & Cosentino, María. (2021). Corneal Remodeling: A New Alternative Technique to Treat Corneal Ectasia. 10.1007/978-3-030-66143-4_10.