Effect of femtosecond and microkeratome flaps creation on the cornea biomechanics during laser in situ keratomileusis： one year follow-up

AIM： To compare the corneal biomechanical outcomes at one year after laser in situ keratomileusis（LASIK） with the flaps created by Ziemer and Moria M2 microkeratome with 110 head and -20 blade.METHODS： Totally 100 eyes of 50 consecutive patients were enrolled in this prospective study and divided into two groups for corneal flaps created by Ziemer Femto LDV and Moria M2 microkeratome with 110 head and -20 blade.Corneal biomechanical properties including cornea resistance factor（CRF） and cornea hysteresis（CH） were measured before and 1,3,6,12 mo after surgery by ocular response analyzer.Central cornea thickness and corneal flap thickness were measured by optical coherence tomography.RESULTS： The ablation depth（P=0.693）,residual corneal thickness（P=0.453）,and postoperative corneal curvature（P=0.264） were not significant different between Ziemer group and Moria 110-20 group after surgery.The residual stromal bed thickness,corneal flap thickness,CH and CRF at 12 mo after surgery were significant different between Ziemer group and Moria 110-20 group（P〈0.01）; Ziemer group gained better corneal biomechanical results.The CRF and CH increased gradually from 1 to12 mo after surgery in Ziemer group,increased from 1 to 6 mo but decreased from 6 to 12 mo in Moria 110-20 group.Both CRF and CH at one year after surgery increased with the increasing of residual cornea thickness; pre-LASIK CRF,CRF also increased with residual stromal bed thickness,while CH decreased with the increasing of pre-LASIK intraocular pressure and cornea flap thickness（P〈0.01）.CONCLUSION： In one year follow-up,femtosecond laser can provide better cornea flaps with stable cornea biomechanics than mechanical microkeratome.

Comparison of visual acuity, refractive results and complications of femtosecond laser with mechanical microkeratome in LASIK

AIM: To compare the outcomes of laser in situ keratomileusis (LASIK) performed with a femtosecond laser (Femtec, Technolas Perfect Vision GmbH, Germany) versus a mechanical microkeratome (Hansatome, Bausch and Lomb, USA) for the correction of myopia and astigmatism. ·METHODS: In this retrospective study, patients who had undergone LASIK using the 80 -kHz Femtec femtosecond laser were compared to age- and refraction- matched patients in whom the Hansatome microkeratome was used. Refractive and visual results 1 month and 3 months postoperatively, and complication rates were compared between the two groups. ·RESULTS: A total of 280 eyes were analyzed (140 in each group). At 3 months postoperatively in the Femtec vs Hansatome group, spherical equivalent refraction was within ±1.00D of emmetropia in 140 vs 138 eyes (P = 0.498), the cylinder was within ±0.50D in 137 vs 139 eyes (P =0.622), and the UDVA was 20/20 or better in 136 vs 137 eyes (P =0.724), respectively. There was no statistically significant difference in the complication rates between the two groups (P =0.099). ·CONCLUSION: LASIK performed both with Femtec femtosecond laser and Hansatome microkeratome achieved satisfactory refractive and visual results at 3 months postoperatively, without significant differences in efficacy, safety, and complication rates between the two procedures.

Comparison of corneal flap thickness using a FS200femtosecond laser and a moria SBK microkeratome

AIMTo evaluate differences in flap thickness resulting from use of an Alcon Wavelight FS200 femtosecond laser and a MORIA SBK microkeratome when making a 110-µm-thick corneal flap and to identify the potential factors that affect corneal flap thickness.

Comparison of the flaps made by femtosecond laser and automated keratomes for sub-bowman keratomileusis

Background Thin-flap laser in situ keratomileusis （LASIK） is the new trend of refractive error correction surgery, the formation of corneal flap is crucial for a success of LASIK surgery. This study aimed to assess and compare the variations of LASIK flap created by the IntraLase femtosecond laser, Moria One Use-Plus SBK and Moria M2 Single-Use 90 pm- head microkeratome using Anterior segment optical coherence tomography （Visante OCT）. Methods One hundred and sixty-one eyes of 81 consecutive patients were enrolled in this prospective study and randomly divided into three groups depending on the flap creation method： flap creation with the the IntraLase femtosecond laser （IntraLase group, 59 eyes）, flap creation with the Moria One Use-Plus SBK （SBK group, 44 eyes）, and flap creation with the Moria M2 Single-Use 90 pm-head microkeratome （M2SU90 group, 58 eyes）. The nominal flap thickness was 110 m for all patients and for the three devices. One month after surgery, Visante OCT was used to measure the flap thickness at 20 locations on each cornea and the results were assessed for uniformity, regularity, and accuracy. Results At 1 month after surgery, the mean central flap thickness was （111±3） pm in the IntraLase group, （114±8） pm in the SBK group, and （118±13） pm in the M2SU90 group respectively. The flaps in the IntraLase group and the SBK group were more regular, showing an almost planar configuration, than the meniscus-shaped flaps in the M2SU90 group. The maximum deviation from the intended flap thickness （110 pm） was 6 pm in the IntraLase group, 10 pm in the SBK group, and 20 pm in the M2SU90 group respectively. A difference greater than 20 pm was observed in 0.42% of measurements in the IntraLase group; 2.95% of the measurements in the SBK group and 21.12% of measurements in the M2SU90 group. Conclusions The flaps created by the IntraLase femtosecond laser and Moria One Use-Plus SBK are more uniform; more regular, and more accurate than those created by the Moria M2 Single-Use 90 pm-head microkeratome. The first two methods can make precise flaps for Sub-Bowman Keratomileusis.