Three-dimensional LASIK flap thickness variability: topographic central, paracentral and peripheral assessment, in flaps created by a mechanical microkeratome (M2) and two different femtosecond lasers (FS60 and FS200)

Kanellopoulos, Anastasios John; Asimellis, George

doi:10.2147/opth.s40762

Cited by 34 publications

(31 citation statements)

References 34 publications

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“…This demonstrated that the thicker corneas were associated with the thicker flaps and the thinner corneas with thinner flaps. Similar results were also reported in previous studies 8,16,24,28,29. We found no correlation between other parameters.…”

Section: Discussionsupporting

confidence: 93%

“…The flap thickness created with different microkeratomes has been shown to be different from the intended values 15–29. In this study, the Moria M2 single-use 90 microkeratome, designed to achieve a corneal thickness of 120 µm was used in all eyes.…”

Section: Discussionmentioning

confidence: 97%

“…On the other hand, when thinner flaps are created, the risk of flap irregularities, buttonholes, and epithelial defects may increase. In addition, flap manipulation may become more difficult and prone to complications, such as folds or striae, and irregular astigmatism may increase 2,7,19,29. Contrary to this, Prandi et al30 reported that complication and retreatment rates were not statistically different among the groups (group 1, flap thickness ≤100 µm; group 2, flap thickness >100 µm and <130 µm; and group 3, flap thickness ≥130 µm).…”

Section: Discussionmentioning

confidence: 98%

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Corneal flap thickness with the Moria M2 single-use head 90 microkeratome in 72 consecutive LASIK procedures

Karabela

Müftüoğlu

Kaya

2017

OPTH

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PurposeThis study aimed to evaluate the accuracy and consistency of corneal flap thickness in laser-assisted in situ keratomileusis (LASIK) with the Moria M2 single-use head 90 microkeratome.MethodsThe central corneal thickness of 72 (37 right, 35 left) eyes of 37 patients was measured by ultrasonic pachymetry preoperatively and intraoperatively after flap cut. The Moria M2 single-use head 90 microkeratome was used to create a superior hinged flap in all eyes. The right eyes were always operated on before the left eyes in each patient, using the same blade in all bilateral cases. All patients underwent LASIK for myopia and/or myopic astigmatism using VISX Star S4 platform.ResultsThe mean preoperative spherical equivalent refraction was −3.55±2.30 D (range: −0.625 to −11.00 D), preoperative central corneal thickness by ultrasonic pachymetry was 541±26.82 µm (490–600 µm) and steepest K was 44.08±1.49 D (40–46.75 D) in all eyes. The mean flap thickness was 136.97±20.07 µm (106–192 µm), 131.2±19.5 µm (91–192 µm), and 134.16±19.85 µm (91–192 µm) in the right, left, and both eyes, respectively. A positive significant relationship was found between flap thickness and preoperative ultrasonic pachymetry thickness. No significant relationship was found between flap thickness and the age, preoperative spherical equivalent, and preoperative steepest K. The difference between the first and second eyes was not significant. There were no major intraoperative and postoperative complications in all eyes.ConclusionThe Moria M2 single-use head 90 microkeratome cut relatively thicker flaps than were intended. The flap thickness range was quite wide. This was a disadvantage for the accuracy and consistency of corneal flap thickness.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 98%

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Corneal flap thickness with the Moria M2 single-use head 90 microkeratome in 72 consecutive LASIK procedures

Karabela

Müftüoğlu

Kaya

2017

OPTH

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“…Creation of a LASIK flap with a femtosecond laser is considered advantageous to microceratome7,8 for a more centered, higher controlled-geometry, both in depth9 as well as diameter 10. In an earlier effort to validate the precision and accuracy of flap creation, we had introduced a quantitative digital analysis technique for accurate measurement of flap diameter and extent of OBL for flaps created using the Alcon/WaveLight FS200 femtosecond laser during LASIK and prior to lifting of the flap 10…”

Section: Discussionmentioning

confidence: 99%

Essential opaque bubble layer elimination with novel LASIK flap settings in the FS200 Femtosecond Laser

Kanellopoulos

Asimellis

2013

OPTH

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BackgroundThe purpose of this study is to evaluate the extent and incidence of opaque bubble layer (OBL) using laser-assisted in situ keratomileusis (LASIK) flaps created with the Alcon/WaveLight® FS200 femtosecond laser as a result of a recent change in flap programming parameters aiming to reduce further the incidence and extent of OBL.MethodsIntraoperative digital images of flaps from 36 consecutive patients (72 eyes) subjected to bilateral femtosecond-assisted LASIK were analyzed using a proprietary computerized technique. The incidence and extent of OBL was measured and reported as a percentage of the entire flap area. Flap creation was performed with a 1.7 mm wide canal, implemented as an updated design intended to reduce the extent of OBL (group A). The same OBL parameters were investigated and compared in an age-matched and procedure-matched patients in whom the previous standard setting of a 1.3 mm wide canal was implemented (group B).ResultsIn group A, the average extent of OBL was 3.69% of the flap area (range 0%–11.34%). In group B, the respective values were 6.06% (range 0%–20.24%). We found the difference to be statistically significant (one-tailed P = 0.00452).ConclusionThis study suggests that there is a significant reduction in the incidence and extent of OBL when novel LASIK flap ventilation canal parameters of width and spot line separation are used.

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“…13 However, the advent of femtosecond lasers definetively enhanced the accuracy, by reducing the standard deviation for flap thickness, as well as improving geometry of the lamellar cut. [13][14][15][16][17] Every surgeon should be alert about such complication and be aware about the standard deviation of the thickness of the flap from the instrumentation he or she has available.…”

Section: Discussionmentioning

confidence: 99%

Unilateral Corneal Ectasia after Bilateral LASIK: The Thick Flap Counts

Valbon¹,

Glicéria²,

Santos³

et al. 2013

International Journal of Keratoconus and Ectatic Corneal Diseases

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Three-dimensional LASIK flap thickness variability: topographic central, paracentral and peripheral assessment, in flaps created by a mechanical microkeratome (M2) and two different femtosecond lasers (FS60 and FS200)

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Cited by 34 publications

References 34 publications

Corneal flap thickness with the Moria M2 single-use head 90 microkeratome in 72 consecutive LASIK procedures

Corneal flap thickness with the Moria M2 single-use head 90 microkeratome in 72 consecutive LASIK procedures

Essential opaque bubble layer elimination with novel LASIK flap settings in the FS200 Femtosecond Laser

Unilateral Corneal Ectasia after Bilateral LASIK: The Thick Flap Counts

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