AIM：To compare recovery of the visual acuity in patients one day after sub-Bowman keratomileusis（SBK）or laser in situ keratomileusis（LASIK）.· METHODS：Data from 5923 eyes in 2968 patients that received LASIK...AIM：To compare recovery of the visual acuity in patients one day after sub-Bowman keratomileusis（SBK）or laser in situ keratomileusis（LASIK）.· METHODS：Data from 5923 eyes in 2968 patients that received LASIK（2755 eyes） or SBK（3168 eyes） were retrospectively analyzed.The eyes were divided into 4groups according to preoperative spherical equivalent：between-12.00 to-9.00 D,extremely high myopia（n =396,including 192 and 204 in SBK and LASIK groups,respectively）;-9.00 to-6.00 D,high myopia（n=1822,including 991 and 831 in SBK and LASIK groups,respectively）,-6.00 to-3.00 D,moderate myopia（n=3071,including 1658 and 1413 in SBK and LASIK groups,respectively）,and-3.00 to 0.00 D,low myopia（n =634,including 327 and 307 in SBK and LASIK groups,respectively）.Uncorrected logMAR visual acuity values of patients were assessed under standard natural light.Analysis of variance was used for comparisons among different groups.· RESULTS：Uncorrected visual acuity values were0.0115±0.1051 and 0.0466±0.1477 at day 1 after operation for patients receiving SBK and LASIK,respectively（P〈0.01）;visual acuity values of 0.1854±0.1842,0.0615±0.1326,-0.0033±0.0978,and-0.0164±0.0972 were obtained for patients in the extremely high,high,moderate,and low myopia groups,respectively（P〈0.01）.In addition,significant differences in visual acuity at day 1 after operation were found between patients receiving SBK and LASIK in each myopia subgroup.· CONCLUSION：Compared with LASIK,SBK is safer and more effective,with faster recovery.Therefore,SBK is more likely to be accepted by patients than LASIK for better uncorrected visual acuity the day following operation.展开更多
AIM: To compare the morphologic characteristics between thin-flap laser in situkeratomileusis (LASIK) and Sub-Bowman keratomileusis (SBK), and to evaluate the uniformity of flap and to explore the correlative factors ...AIM: To compare the morphologic characteristics between thin-flap laser in situkeratomileusis (LASIK) and Sub-Bowman keratomileusis (SBK), and to evaluate the uniformity of flap and to explore the correlative factors of corneal flap thickness. METHODS: A prospective, randomized, comparative clinical study was performed in Department of Ophthalmology, West Hospital of China, Chengdu, Sichuan Province, China. Totally 59 patients 114 eyes underwent LASIK or SBK to correct myopia, 29 patients 57 eyes underwent SBK, 30 patients 57 eyes underwent LASIK. Anterior optical coherence tomography (OCT) was used to measure corneal flap thickness in all the patients 1 week after surgeries, 16 positions were set to be measured in each eye. Comparisons of flap thickness in each group and between 2 groups were evaluated. Correlative factors of flap thickness were evaluated. RESULTS: Coefficient of variation(CV, s/((X) over bar)x%)in SBK group were lesser than that in LASIK group, ttest showed there was significant statistical difference between 2 groups (P=0.000). Comparisons of the difference of 2 paired positions (temporal-nasal; superior-inferior) showed there were no significant differences in each group, but between 2 groups, there were statistical significance of value of difference (D-value) of superior and inferior positions between SBK and LASIK group (P =0.036). Linear regression analysis of correlative factors of flap thickness showed there were no statistic significances related to central corneal thickness(CCT) (P =0.060, t=1.921)and corneal curvature( P=0.083, t=1.766). CONCLUSION: SBK is better than LASIK in a-eating much uniform corneal flap. There was no evidence showing correlations between flap thickness and CCT or corneal curvature.展开更多
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 ...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.展开更多
Flaporhexis, a technique to make the femtosecond laser corneal flap was developed primarily to reduce the mechanical trauma associated with separating the corneal tissue by taking advantage of the cornea’s natural an...Flaporhexis, a technique to make the femtosecond laser corneal flap was developed primarily to reduce the mechanical trauma associated with separating the corneal tissue by taking advantage of the cornea’s natural anatomy and was first described in a peer reviewed artice in 2008. The anterior part of the cornea tends to be stronger, thereby allowing tearing (Greek “rhexis”) along the preformed cuts of the femtosecond photo disruption. Flaporhexis differs from Binder’s technique of “hinge opening” as published in 2006 by opening the flap from the opposite side. If a femtosecond flap lift is performed correctly, the surgeon will find a virgin, uniform, dry stromal bed, which had not been manipulated by any surgical instrument and is therefore perfect for wavefront guided laser surgery as “Sub-Bowman’s Keratomileusis”.展开更多
基金Supported by the National Natural Science Foundation of China(No.81000391,No.81370020)
文摘AIM：To compare recovery of the visual acuity in patients one day after sub-Bowman keratomileusis（SBK）or laser in situ keratomileusis（LASIK）.· METHODS：Data from 5923 eyes in 2968 patients that received LASIK（2755 eyes） or SBK（3168 eyes） were retrospectively analyzed.The eyes were divided into 4groups according to preoperative spherical equivalent：between-12.00 to-9.00 D,extremely high myopia（n =396,including 192 and 204 in SBK and LASIK groups,respectively）;-9.00 to-6.00 D,high myopia（n=1822,including 991 and 831 in SBK and LASIK groups,respectively）,-6.00 to-3.00 D,moderate myopia（n=3071,including 1658 and 1413 in SBK and LASIK groups,respectively）,and-3.00 to 0.00 D,low myopia（n =634,including 327 and 307 in SBK and LASIK groups,respectively）.Uncorrected logMAR visual acuity values of patients were assessed under standard natural light.Analysis of variance was used for comparisons among different groups.· RESULTS：Uncorrected visual acuity values were0.0115±0.1051 and 0.0466±0.1477 at day 1 after operation for patients receiving SBK and LASIK,respectively（P〈0.01）;visual acuity values of 0.1854±0.1842,0.0615±0.1326,-0.0033±0.0978,and-0.0164±0.0972 were obtained for patients in the extremely high,high,moderate,and low myopia groups,respectively（P〈0.01）.In addition,significant differences in visual acuity at day 1 after operation were found between patients receiving SBK and LASIK in each myopia subgroup.· CONCLUSION：Compared with LASIK,SBK is safer and more effective,with faster recovery.Therefore,SBK is more likely to be accepted by patients than LASIK for better uncorrected visual acuity the day following operation.
文摘AIM: To compare the morphologic characteristics between thin-flap laser in situkeratomileusis (LASIK) and Sub-Bowman keratomileusis (SBK), and to evaluate the uniformity of flap and to explore the correlative factors of corneal flap thickness. METHODS: A prospective, randomized, comparative clinical study was performed in Department of Ophthalmology, West Hospital of China, Chengdu, Sichuan Province, China. Totally 59 patients 114 eyes underwent LASIK or SBK to correct myopia, 29 patients 57 eyes underwent SBK, 30 patients 57 eyes underwent LASIK. Anterior optical coherence tomography (OCT) was used to measure corneal flap thickness in all the patients 1 week after surgeries, 16 positions were set to be measured in each eye. Comparisons of flap thickness in each group and between 2 groups were evaluated. Correlative factors of flap thickness were evaluated. RESULTS: Coefficient of variation(CV, s/((X) over bar)x%)in SBK group were lesser than that in LASIK group, ttest showed there was significant statistical difference between 2 groups (P=0.000). Comparisons of the difference of 2 paired positions (temporal-nasal; superior-inferior) showed there were no significant differences in each group, but between 2 groups, there were statistical significance of value of difference (D-value) of superior and inferior positions between SBK and LASIK group (P =0.036). Linear regression analysis of correlative factors of flap thickness showed there were no statistic significances related to central corneal thickness(CCT) (P =0.060, t=1.921)and corneal curvature( P=0.083, t=1.766). CONCLUSION: SBK is better than LASIK in a-eating much uniform corneal flap. There was no evidence showing correlations between flap thickness and CCT or corneal curvature.
文摘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.
文摘Flaporhexis, a technique to make the femtosecond laser corneal flap was developed primarily to reduce the mechanical trauma associated with separating the corneal tissue by taking advantage of the cornea’s natural anatomy and was first described in a peer reviewed artice in 2008. The anterior part of the cornea tends to be stronger, thereby allowing tearing (Greek “rhexis”) along the preformed cuts of the femtosecond photo disruption. Flaporhexis differs from Binder’s technique of “hinge opening” as published in 2006 by opening the flap from the opposite side. If a femtosecond flap lift is performed correctly, the surgeon will find a virgin, uniform, dry stromal bed, which had not been manipulated by any surgical instrument and is therefore perfect for wavefront guided laser surgery as “Sub-Bowman’s Keratomileusis”.
