The Ziemer LDV Z8 is a new high-frequency, high-precision, femtosecond laser system for efficient cataract surgery with a fast, smooth workflow and the patient remaining in one place throughout the procedure. The Z8 is the latest development from Port, Switzerland-based Ziemer Ophthalmic Systems AG’s line of Femto LDV Z laser platforms that support cornea, presbyopia and cataract surgery, and include Z2, Z4, and Z6 models.
Its combination of low energy and high pulse repetition rate differentiate the Ziemer LDV Z8 from previous systems. The spots overlap, making a real cut, with no tissue bridges, 
commented Bojan Pajic, MD, PhD, FEBO, Medical Director for Orasis Opthalmic, a refractive surgery clinic at Reinach, Switzerland, in a presentation at the winter meeting of the European Society of Cataract and Refractive Surgeons held February 20 – 22, 2015 at the Hilton Istanbul Bosphorus in Istanbul, Turkey. Dr. Pajic noted that the LDV Z8’s 
combination of low energy and a high pulse repetition rate differentiates it from previous systems.
The FEMTO LDV Z devices operate with very low pulse energy and very short pulse width, and with very high pulse frequencies in the megahertz range. Additionally, the threshold for tissue disruption is reached without requiring an amplifier. Zeimers say this low energy delivery has turned out to be the most relevant factor for a gentle tissue resection, and that the FEMTO LDV Z8 is the first real mobile femtosecond laser for both refractive and cataract surgery. A proprietary OCT system with automatic pupil and limbal recognition supports the surgery, providing three-dimensional viewing of the anterior segment. (Note: the FEMTO LDV Z8 is CE marked but not yet cleared by the FDA for the use in the United States).
FEMTO LDV Z6 targets the whole anterior segment, enabling surgeons to perform perfect lamellar and penetrating keratoplasties, intracorneal rings and pockets, Z-LASIK and Z-LASIK Z as well as clear corneal incisions and arcuate incisions.
The FEMTO LDV Z4 offers Ziemer femtosecond laser technology in every axis, with three dimensional resection that extends the range of surgical procedures enabling surgeons to perform Z-LASIK Z, intracorneal rings, intrastromal pockets or the classic Z-LASIK. Thanks to the Ziemer laser architecture, the spots remain ultra small and completely overlap, providing precision focus quality while using low energy at what is claimed to be the highest repetition rate among all modern femtosecond laser systems.
The company also notes that the FEMTO LDV Z2 is a cost effective femtosecond laser for general purpose use in refractive clinics. In conjunction with state-of-the-art eximer lasers, the FEMTO LDV systems are heralded as facilitating achievement of superior short-term results as well as excellent long-term visual outcomes in femto-LASIK procedures, with over two million patients having been successfully treated with this Z-LASIK procedure.
FEMTO LDV systems support cornea, presbyopia and cataract surgery on one femto platform.
A trial entitled “FEMTO LDV Z6 And Z8: Experience With Incisions And Cataract Pre-treatments“ conducted by Dr. Pajic evaluated surgical outcomes and safety of the new FEMTO LDV Z8 femtosecond laser platform. Seventeen patients with a mean age of 72.99 participated in the study.
The Z8’s imaging OCT technology is designed to help place resections, to visualize the resection positions, and to fine adjust the position with automatic pupil and Limbus recognition, providing improved real time imaging (docking and planning) and three-dimensional visualization of the anterior segment.
Clinical data results included:
- Capsulotomy – Very precise in size and shape, with a diameter at 5.0 mm as intended – Capsulotomies are excellent (free floating)
- Fragmentation – Excellent resection quality in all patients, cataract grade 2 to 4.
- General – No blackout reported
- Preparation time for the femtosecond laser before surgery: 3.60.7 min
In his clinical data conclusions, Dr. Pajic notes: “The capsulotomies were precise and reproducible. The capsule disks created by the laser were easy to remove. Lens fragmentation was efficient even in a patient with a cataract grade 4 . Pulse energy in nanojoules range (low energy). Lens fragmentation was done prior to capsulotomy, proving the low amount of gas created in the capsule. High precision and customized cutting. The workflow remained the same as for the standard manual cataract surgery (Single working position, no patient move). Very low vacuum. Short learning curve.”
For more information about the Femto LDV Z devices, contact: Ziemer Ophthalmic Systems AG.
U.S. Offices
http://www.ziemerusa.com/
Sources:
Ziemer Ophthalmic Systems AG
Orasis Opthalmic
Image Credits:
Ziemer Ophthalmic Systems AG
Orasis Opthalmic
