FLEx: just as effective but cheaper than Femto-LASIK

Refractive outcomes for Femtosecond Lenticule Extraction (FLEx) are getting close to those of eximer-based Femto-LASIK, and patients are expressing high degrees of satisfaction with both techniques, Dr Walter Sekundo told delegates at a session on current trends in laser refractive surgery.

Dr Sekundo presented the latest findings on his experience with the FLEx procedure. He outlined the essentials of the procedure, explaining that it required four steps. FS-laser processing of the lenticule front side, the lenticule backside, the flap side cut and then lenticule removal after the flap opening.

"There is a learning curve with FLEx, as there is with any new technique, but the results have been improving dramatically," he said.

He said that in the first 21 eyes he operated using FLEx, 57% of patients were within 0.5 D of target refraction. "But in the last 61 eyes I've operated, 77% of them were within a half diopter of the target refraction. Those results will continue to improve," he said.

Dr Sekundo presented the findings of a recent study he conducted with his FLEx patients. There were 10 eyes in five patients with a MSE of -4.9 D using the latest VisuMax software and all procedures were performed within last two months

"Earlier procedures were using an earlier version of the software and that had an impact on the results with earlier patients. The software is being refined all the time and that is reflected in the outcome.

After one month, all eyes were within 0.5 D of intended correction and all eyes had 20/25 or better UCVA, with eight of the 10 eyes at 20/20 or better UCVA.

Dr Sekundo concluded that refractive outcomes of FLEx are getting close to those of the excimer-based femto-LASIK and that there is a high degree of satisfaction rate with both techniques.

"So why bother with FLEx? Well, for a start there is a tendency for better refractive stability with FLEx, and the workflow is a lot simpler too. You are using just one machine to do the procedure," he said.

He said that this meant that acquisition and service costs were lower too. "It means that the procedure is cheaper for patients too, because I don't think it is ethical to charge the same if the procedure is costing you less," he added.

He said resection is less dependent on environmental factors compared with ablation. But, in perhaps the most compelling argument for FLEx, he said that the technique was just in its infancy and opens up the way to new approaches to old clinical problems. "For example, there is the potential for small incision FLEx in the future."