In Vivo Structural Characteristics of the Femtosecond LASIK-Induced Opaque Bubble Layers with Ultrahigh-Resolution SD-OCT

Hürmeriç, Volkan; Yoo, Sonia H.; Fishler, Jane; Chang, Victoria; Wang, Jianhua; Culbertson, William W.

doi:10.3928/15428877-20101031-08

Cited by 28 publications

(17 citation statements)

References 11 publications

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“…OBL located above the flap interface has been observed in patients with undissected flap zone. This pattern of OBL has been suggested to be a contraindication to flap lifting [76].…”

Section: Ultra-high-resolution Octmentioning

confidence: 97%

“…It can be used in several problems encountered during femtosecond laser-assisted surgery in which histological ana lysis is technically impossible. One of the recent clinical applications of UHR-OCT is the evaluation of the opaque bubble layer (OBL) [76]. OBL is the accumulation of gas bubbles in the corneal stroma during femtosecond laser-assisted LASIK flap creation.…”

Section: Ultra-high-resolution Octmentioning

confidence: 99%

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Optical coherence tomography in cornea and refractive surgery

Hürmeriç

Yoo

Mutlu³

2012

Expert Review of Ophthalmology

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Optical coherence tomography (OCT) is the most promising imaging technique used in ophthalmology today. Noninvasive, noncontact and having quick image acquisition makes OCT a requirement in ophthalmology practice. OCT can be used to gain cross-sectional images of the anterior and posterior segment of the eye. In cornea and refractive surgery anterior segment OCT (AS-OCT) is used in presurgical planning and postsurgical evaluation. AS-OCT is especially needed in phakic intraocular lens implantation, laser-assisted in situ keratomileusis enhancement and lamellar keratoplasty. There are also various promising advancements in AS-OCT imaging, such as intraoperative OCT and ultra-high-resolution OCT. These techniques offer new therapeutic and diagnostic options with increased resolution and improved scanning time.

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“…OBL located above the flap interface has been observed in patients with undissected flap zone. This pattern of OBL has been suggested to be a contraindication to flap lifting [76].…”

Section: Ultra-high-resolution Octmentioning

confidence: 97%

Section: Ultra-high-resolution Octmentioning

confidence: 99%

Optical coherence tomography in cornea and refractive surgery

Hürmeriç

Yoo

Mutlu³

2012

Expert Review of Ophthalmology

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“…The OBL can be described simply as temporary “debris” as a result of the intracorneal femtosecond laser ablation progressively generating air that cannot escape in a timely manner 11. The presence of an OBL has no known adverse effects, except for temporarily obscuring the architectural landmarks of the iris, and possibly the pupil image that excimer laser trackers use in intraoperative tracking.…”

Section: Introductionmentioning

confidence: 99%

Digital analysis of flap parameter accuracy and objective assessment of opaque bubble layer in femtosecond laser-assisted LASIK: a novel technique

Kanellopoulos

Asimellis²

2013

OPTH

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Background:The purpose of this study was to determine flap parameter accuracy, extent of the opaque bubble layer, and incidence of skip lines in femtosecond laser-assisted stromal in situ keratomileusis (LASIK) using the WaveLight® FS200 laser and optoelectronic clinical measurements.Methods:Images from 101 flaps were automatically recorded during consecutive routine LASIK procedures performed using the WaveLight FS200 femtosecond laser and the EX500 excimer laser. Digital processing of these images was used to evaluate objectively the diameter of FS200-created flaps, by comparing planned versus achieved procedures and to evaluate the incidence and extent (area) of the opaque bubble layer.Results:The intended flap diameters were between 8.00 mm and 9.50 mm. The achieved flap diameters showed extremely high precision, and were on average −0.16 ± 0.04 mm smaller for a 8.00 mm intended flap diameter, −0.12 ± 0.03 mm smaller for a 8.50 mm flap, and up +0.06 ± 0.06 mm wider for a 9.50 mm flap. With an average flap area of 72.4 mm2, the mean area of the opaque bubble layer (4.1 ± 4.3 [range 0–14.34] mm2) corresponded to a 6% opaque bubble layer-to-flap area. Specifically, 80% of the femtosecond-created flaps had an essentially zero opaque bubble layer (<2.7% of the flap area).Conclusion:In our clinical experience, flaps created using FS200 and this novel highly objective assessment technique demonstrate both precision and reproducibility. The incidence of opaque bubble layer was minimal.

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“…Currently it has widespread use in clinical diagnosis and in the treatment of anterior segment diseases. 11–14 It is also capable of exploring changes in anterior chamber dimensions and lens thickness with aging and accommodation. 5,15–17 However, simultaneous imaging of the whole anterior segment, including the cornea, iris, anterior chamber, and crystalline lens, cannot be accomplished by the commercially available OCT instruments because the imaging depth, ~6 mm, is too short, and the imaging speed, ~4,000 A-scans/sec, is too slow.…”

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confidence: 99%

Anterior Segment Biometry during Accommodation Imaged with Ultralong Scan Depth Optical Coherence Tomography

Shen

et al. 2012

Ophthalmology

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Purpose To measure by ultra-long scan depth optical coherence tomography (UL-OCT) dimensional changes in the anterior segment of human eyes during accommodation. Design Evaluation of diagnostic test or technology. Participants Forty-one right eyes of healthy subjects with a mean age of 34 years (range, 22–41 years) and a mean refraction of −2.5±2.6 diopters (D) were imaged in two repeated measurements at minimal and maximal accommodation. Methods A specially adapted designed UL-OCT instrument was used to image from the front surface of the cornea to the back surface of the crystalline lens. Custom software corrected the optical distortion of the images and yielded the biometric measurements. The coefficient of repeatability (COR) and the intraclass correlation coefficient (ICC) were calculated to evaluate the repeatability and reliability. Main Outcome Measures Anterior segment parameters and associated repeatability and reliability upon accommodation. The dimensional results included central corneal thickness (CCT), anterior chamber depth and width (ACD, ACW), pupil diameter (PD), lens thickness (LT), anterior segment length (ASL=ACD+LT), lens central position (LCP=ACD+1/2LT) and horizontal radii of the lens anterior and posterior surface curvatures (LAC, LPC). Results Repeated measurements of each variable within each accommodative state did not differ significantly (P>0.05). The CORs and ICCs for CCT, ACW, ACD, LT, LCP, and ASL were excellent (1.2% to 3.59% and 0.998 to 0.877, respectively). They were higher for PD (18.90% to 21.63% and 0.880 to 0.874, respectively), and moderate for LAC and LPC (34.86% to 42.72% and 0.669 to 0.251, respectively) in the two accommodative states. Compared to minimal accommodation, PD, ACD, LAC, LPC, and LCP decreased and LT and ASL increased significantly at maximal accommodation (P<0.05), while CCT and ACW did not change (P>0.05). Conclusions UL-OCT measured changes in anterior segment dimensions during accommodation with good repeatability and reliability. During accommodation, the back surface of the lens became steeper as the lens moved forward.

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In Vivo Structural Characteristics of the Femtosecond LASIK-Induced Opaque Bubble Layers with Ultrahigh-Resolution SD-OCT

Cited by 28 publications

References 11 publications

Optical coherence tomography in cornea and refractive surgery

Optical coherence tomography in cornea and refractive surgery

Digital analysis of flap parameter accuracy and objective assessment of opaque bubble layer in femtosecond laser-assisted LASIK: a novel technique

Anterior Segment Biometry during Accommodation Imaged with Ultralong Scan Depth Optical Coherence Tomography

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