Moving from a Mechanical Microkeratome to a Femtosecond Laser for LASIK to Correct Astigmatic Patients: Clinical Outcomes of a Retrospective, Consecutive, Comparative Study

Guber, Ivo; Moetteli, Leila; Magnin, L.; Majo, F.

doi:10.1055/s-0032-1328384

Cited by 4 publications

(3 citation statements)

References 22 publications

(28 reference statements)

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“…Particularly the quest for intrastromal lenticules was pursued since the inception of femtosecond lasers [24]. The first company to develop a commercial instrument realizing corneal flaps was Intralase, with which more predictable flap thickness [25,26] and dimensions [27], better astigmatic neutrality [28], and decreased epithelial injury was demonstrated compared to two popular mechanical microkeratomes [29]. However, some specific femtoLASIK complications have been also discovered [30][31][32][33].…”

Section: Introductionmentioning

confidence: 99%

Analytical optimization of the laser induced refractive index change (LIRIC) process: maximizing LIRIC without reaching the damage threshold

Arba-Mosquera

Krüger

Naubereit

et al. 2021

Advanced Optical Technologies

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A method to determine the optimum laser parameters for maximizing laser induced refractive index change (LIRIC) while avoiding exceeding the damage threshold for different materials with high water content (in particular, polymers such as hydrogels or the human cornea) is proposed. The model is based upon two previous independent models for LIRIC and for laser induced optical breakdown (LIOB) threshold combined in a simple manner. This work provides qualitative and quantitative estimates for the parameters leading to a maximum LIRIC effect below the threshold of LIOB.

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Section: Introductionmentioning

confidence: 99%

Analytical optimization of the laser induced refractive index change (LIRIC) process: maximizing LIRIC without reaching the damage threshold

Arba-Mosquera

Krüger

Naubereit

et al. 2021

Advanced Optical Technologies

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“…The microkeratome technology still represents a reliable method for customized LASIK procedures. 6 , 27 , 29 , 30 Nevertheless, the LDV femtosecond laser provides superior results by more closely creating the desired flap thickness, thus accelerating the visual recovery in comparison to microkeratome. 7 , 24 , 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

Femtosecond laser versus mechanical microkeratome-assisted flap creation for LASIK: a prospective, randomized, paired-eye study

Pajic¹,

Vastardis

Pajic-Eggspuehler³

et al. 2014

OPTH

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PurposeTo compare a femtosecond laser with a microkeratome for flap creation during laser in situ keratomileusis (LASIK) in terms of flap thickness predictability and visual outcomes.Patients and methodsThis was a prospective, randomized, masked, paired-eye study. Forty-four patients (34 females) who received bilateral LASIK were included. Patients were stratified by ocular dominance, and they then underwent randomization of flap creation using the femtosecond laser on one eye and undergoing the microkeratome procedure on the other one. The visual outcome differences between the corrected distance visual acuity (CDVA) at baseline and the uncorrected distance visual acuity (UDVA) on the first day postoperatively were set as the efficiency index for both groups. All visual acuity outcome results and the deviation of flap thickness were evaluated. P-values <0.05 were considered statistically significant.ResultsThe index of efficiency regarding the postoperative visual outcomes in the microkeratome group was lower (P<0.0001). This result was correlated with the difference between intended and achieved flap thickness (P=0.038; r=0.28), and a negative relationship in the regression analysis was confirmed (P<0.04; R2=0.1428). The UDVA in the microkeratome group improved significantly by the end of the first month (P<0.0271) in comparison to the baseline CDVA. The deviation between intended and postoperative flap thickness using either optical coherence pachymetry or Heidelberg Retinal Tomography II confocal microscopy was statistically significant (paired t-test; P<0.001) between the groups. The flap thickness deviation in the microkeratome group was higher. In the femtosecond laser group, the efficiency index was stable postoperatively (P=0.64) The UDVA improved significantly by the end of the first postoperative week (P=0.0043) in comparison to the baseline CDVA. Six months after surgery, improvement in the UDVA was significant in both groups (all P<0.001; one way analysis of variance).ConclusionFemtosecond laser was superior to microkeratome-assisted LASIK in terms of flap thickness predictability and the speed of visual acuity recovery. A negative relationship in the regression analysis between increasing flap thickness deviation and visual acuity recovery was confirmed.

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“…Femtosecond laser not only produce an individualized flap but also have been associated with improvements in uncorrected distance visual acuity (UCVA), more stable biomechanics, and decreased epithelial injury postoperatively. [ 7 8 9 10 ] However, despite high success rates of FS-LASIK, side effects such as dryness, glare, haloes, and flap-related complications remain a significant concern. [ 11 12 ]…”

mentioning

confidence: 99%

Comparison of changes in refractive error and corneal curvature following small-incision lenticule extraction and femtosecond laser-assisted in situ keratomileusis surgery

Zhang

Cao

Chen

et al. 2018

Indian J Ophthalmol

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Purpose:To compare visual acuity, refractive error, corneal curvature, and the stability of these parameters during the early postoperative period following small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) surgery.Methods:One hundred and five eyes and 110 eyes were enrolled in SMILE and FS-LASIK group, respectively. Uncorrected and best-corrected distance visual acuity (UCVA and BCVA), manifest refraction, corneal curvature, intraocular pressure, and slit-lamp examinations were performed preoperatively, 1 day, 1 week, 1 month, and 3 months postoperatively.Results:No significant differences in postoperative UCVA or BCVA were observed between the SMILE and FS-LASIK groups at any time point. SMILE group had significant better postoperative spherical equivalent (SE) values than FS-LASIK group at 1 day, 1 week, and 1-month follow-up. However, there was no significant difference in postoperative SE values at 3-month follow-up. Significant differences in mean postoperative corneal curvature were observed during all follow-up examinations.Conclusion:SMILE surgery was associated with more accurate postoperative refractive correction up to 1 month following surgery. SMILE surgery also resulted in less significant corneal curvature changes than FS-LASIK. Furthermore, FS-LASIK was associated with decreased stability of postoperative refractive error and corneal curvature relative to SMILE.

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Moving from a Mechanical Microkeratome to a Femtosecond Laser for LASIK to Correct Astigmatic Patients: Clinical Outcomes of a Retrospective, Consecutive, Comparative Study

Cited by 4 publications

References 22 publications

Analytical optimization of the laser induced refractive index change (LIRIC) process: maximizing LIRIC without reaching the damage threshold

Analytical optimization of the laser induced refractive index change (LIRIC) process: maximizing LIRIC without reaching the damage threshold

Femtosecond laser versus mechanical microkeratome-assisted flap creation for LASIK: a prospective, randomized, paired-eye study

Comparison of changes in refractive error and corneal curvature following small-incision lenticule extraction and femtosecond laser-assisted in situ keratomileusis surgery

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