Analysis of Planned and Postoperatively Measured Flap Thickness After LASIK Using the LenSx Multifunctional Femtosecond Laser System

Abstract

Application of this multifunctional femtosecond laser performing LASIK proved to be a safe and effective method regarding predictability of flap thickness.

The Impact of Learning Curve on Flap Thickness Outcome in Femtosecond Laser-assisted Laser In Situ Keratomileusis Performed with New LenSx Dual Platform

“…Notably, data from a past study among experienced and novice LASIK surgeons indicated a fellowship-training program based on a standardized surgical protocol to result in statistically comparable outcomes between an expert surgeon and a fellowship-trained surgeon when newly transitioned from mechanical microkeratome to a FS laser flap creation. [20] However, it should be noted that, while FS laser-created LASIK flap has been reported to be a uniform flap that may contribute to more predictable refractive and wavefront outcomes, [5,9,21] the clinical relevance of FS laser is considered to remain controversial. [5,19] In a past study comparing iFS 150-kHz vs. LenSx FS lasers in correction myopia, authors reported association of iFS 150 kHz with significantly lower intra-FT range at…”

“…According to our experience, in the first 20 operations flaps were thinner than planned by −4.6 μm and SD of FT was 10.8 μm (range, −9.3 to +11.3 μm), whereas in the next 50 operations, flaps were thicker than planned by +3.0 μm and SD of FT was 6.6 μm (range, −11.0 to +13.7 μm). Notably, in the first study to evaluate the visual outcomes and FT accuracy of the LASIK performed with new LenSx multifunctional FS laser system (Alcon Laboratories) by Juhasz et al [ 9 ], the authors reported good visual results and a high FT predictability with the LenSx device when they performed a targeted thick corneal flap of 140 μm in all cases. However, they also emphasized that after gaining an initial experience with the device, the FT was set to the current depth of 110 μm for use in our everyday clinical practice [ 9 ].…”

“…Notably, in the first study to evaluate the visual outcomes and FT accuracy of the LASIK performed with new LenSx multifunctional FS laser system (Alcon Laboratories) by Juhasz et al [ 9 ], the authors reported good visual results and a high FT predictability with the LenSx device when they performed a targeted thick corneal flap of 140 μm in all cases. However, they also emphasized that after gaining an initial experience with the device, the FT was set to the current depth of 110 μm for use in our everyday clinical practice [ 9 ].…”

“…However, it should be noted that, while FS laser-created LASIK flap has been reported to be a uniform flap that may contribute to more predictable refractive and wave-front outcomes [ 5 , 9 , 21 ], the clinical relevance of FS laser is considered to remain controversial [ 5 , 19 ]. In a past study comparing iFS 150-kHz (Abbott Medical Optics, Santa Ana, CA, USA) versus LenSx FS lasers in correction myopia, authors reported association of iFS 150 kHz with significantly lower intra-FT range at every postoperative time point, thus suggesting that this device creates more predictable and more uniform flaps compared with LenSx [ 5 ].…”

“…[5,8] Although the perceived benefits are promising in terms of good visual outcomes and acceptable flap thickness predictability, there is limited published evidence regarding the corneal flap morphology outcome of the dual LenSx FS laser (Alcon Laboratories, Inc, Aliso Viejo, CA) device using curved applanation cone. [5,9] Indeed, the learning curve of surgeons, and the lack of sufficient data on safety profiles of FS laser technology overall, not only for the new LenSx dual platform, are considered amongst the major barriers in use of FS lasers for LASIK in real-life clinical practice. [10] Notably, moistness status of the contact surface is of critical importance in using the curved applanation cone.…”