Sonia Yoo MD, discusses femtosecond laser technology with retina editor Dr. David Goldman. Versus a standard microkeratome, a femtosecond laser is more apt to suffer epithelial breakthrough. This is handled by increasing flap thickness. Second pass is possible in the event of suction loss only in certain circumstances. Enhancements can be done with femtosecond flaps (only 4 year data available). Recutting a fresh side-cut may be done to minimize epithelial ingrowth risk. The lamellar cut isn't necessary in most cases. Other applications of the femtosecond laser: anterior lamellar keratoplasty. Full-thickness penetrating keratoplasty. Femtosecond PK allows for precise incisions and customized shapes to enhance patient outcomes.