Thin flap laser in situ keratomileusis: Analysis of contrast sensitivity, visual, and refractive outcomes

Abstract

Thin flap LASIK is a safe technique to correct myopic defects since it blends the advantages of surface and lamellar procedures (minimal debilitation of corneal biomechanical architecture with the rapid and comfortable visual recovery of lamellar approaches). Moreover, it achieves excellent refractive outcomes, a lower rate of enhancements, and a good visual performance with better contrast sensitivity test results.

Blade source effect on laser in situ keratomileusis flap thickness with the Amadeus I microkeratome

“…10,11 The ability to create reproducibly thin LASIK flaps may not only reduce the risk for ectasia, it may also improve postoperative visual outcomes. [12][13][14] The purpose of this study was to evaluate the accuracy and precision of LASIK flap thickness produced by the Amadeus I microkeratome (Ziemer Ophthalmic Systems) using Surepass blades (Surgical Instrument Systems) and ML7090 CLB blades (Med-Logics, Inc.) …”

Thin-flap LASIK with a High-frequency, Low-energy, Small Spot Femtosecond Laser – Effectiveness and Safety

“…1,6,7 Sub-Bowman keratomileusis (SBK) is a laser procedure that involves the use of a customised corneal flap between 90 and 110 µm with a diameter that is closely matched to the ablation zone of the excimer laser being used, typically ± 8.5 mm.…”

“…The demand to correct larger amounts of ametropia, the development of customised ablation techniques with a trend towards enlarging the diameter of laser ablations, the inducement of aberrations by deep lamellar keratectomies and the increasing incidence of post-laser in situ keratomileusis (LASIK) corneal ectasia have caused surgeons to reconsider the ideal flap thickness and to develop techniques for achieving thinner flaps. 1 Variability of flap thickness limits the reliability of calculations of RSB, which can be critical in the correction of high myopia or LASIK in eyes with a thin cornea. [1][2][3][4][5] A thin flap may thus be desirable: it enables the treatment of higher corrections, permits larger ablation zones, induces fewer aberrations, has a lower enhancement rate and better functional results than a conventional >100 µm flap.…”

“…1 Variability of flap thickness limits the reliability of calculations of RSB, which can be critical in the correction of high myopia or LASIK in eyes with a thin cornea. [1][2][3][4][5] A thin flap may thus be desirable: it enables the treatment of higher corrections, permits larger ablation zones, induces fewer aberrations, has a lower enhancement rate and better functional results than a conventional >100 µm flap. Moreover, thin flaps help to maximise the RSB -staying further away from the critical 250 µm barrier -and preserve the biomechanical stability of the cornea, hence reducing the risk of ectasia.…”

“…1,6,7 Sub-Bowman keratomileusis (SBK) is a laser procedure that involves the use of a customised corneal flap between 90 and 110 µm with a diameter that is closely matched to the ablation zone of the excimer laser being used, typically ± 8.5 mm. 8 One of the principal concerns in thin-flap LASIK is that very thin flaps induce the risk of intraoperative complications (pseudo-buttonhole): the thinner the flap, the closer you get to Bowman's layer.…”