One thousand consecutive IntraLase laser in situ keratomileusis flaps

PURPOSE: To measure laser in situ keratomileusis (LASIK) flap dimensions created with the IntraLase FS (IL) laser (Intralase Corporation). SETTING: Private practice, San Diego, California, USA. METHODS: Consecutive LASIK flaps created with the IL were measured with subtraction ultrasound at primary and enhancement surgeries. Data were stored in Outcomes Analysis Software and analyzed using MS Excel (Microsoft Corporation) and SSPS software. RESULTS: The mean achieved flap thickness exceeded the attempted by 9.4 to 34.3 μm. The standard deviation varied from ±10.2 to ±21.7 μm. Preoperative corneal thickness and power did not affect achieved flap thickness. Seventy‐three percent of mate eye flaps were within ±15 μm of each other for the 90 μm attempted. The same flaps measured at enhancement were thicker than the primarily measured flaps (n = 58). Diffuse lamellar keratitis and slipped flaps were eliminated with experience. There were no decentered or irregular flaps, epithelial defects, or flap perforations. CONCLUSIONS: Compared with published results of mechanical microkeratomes, the IL reduced the standard deviation of flap thickness as well as the achieved range. It eliminated physical complications associated with mechanical flap creation, and the impact of preoperative pachymetry and corneal power, thereby permitting more myopia to be corrected without risking deep ablations.

[1]  A Langenbucher,et al.  Experimental evaluation of two current-generation automated microkeratomes: the Hansatome and the Supratome. , 2000, American journal of ophthalmology-glaucoma.

[2]  M. Arbelaez Nidek MK 2000 microkeratome clinical evaluation. , 2002, Journal of refractive surgery.

[3]  L. G. Pallikaris,et al.  Laser in situ keratomileusis , 1990, Lasers in surgery and medicine.

[4]  G. Shemesh,et al.  Predictability of corneal flap thickness in laser in situ keratomileusis using three different microkeratomes. , 2002, Journal of refractive surgery.

[5]  P. Binder Ectasia after laser in situ keratomileusis , 2003, Journal of cataract and refractive surgery.

[6]  A. Behrens,et al.  Evaluation of corneal flap dimensions and cut quality using a manually guided microkeratome. , 1999, Journal of refractive surgery.

[7]  Guy M Kezirian,et al.  Comparison of the IntraLase femtosecond laser and mechanical keratomes for laser in situ keratomileusis , 2004, Journal of cataract and refractive surgery.

[8]  C. Joo,et al.  Corneal flap thickness in laser in situ keratomileusis using an SCMD manual microkeratome. , 1999, Journal of cataract and refractive surgery.

[9]  F. Hoffmann The Berlin Microkeratome , 1995 .

[10]  P. Binder,et al.  Precision of flap measurements for laser in situ keratomileusis in 4428 eyes. , 2003, Journal of refractive surgery.

[11]  E. Zavala,et al.  Refractive keratoplasty: microkeratome evaluation. , 1982, Archives of ophthalmology.

[12]  R. Lambert,et al.  Comparison of two microkeratome systems. , 1997, Journal of refractive surgery.

[13]  A. Cheng,et al.  Reproducibility of corneal flap thickness in laser in situ keratomileusis using the Hansatome microkeratome. , 2001, Journal of cataract and refractive surgery.

[14]  T. Deutsch,et al.  Reproducibility of corneal flap thickness in LASIK. , 1999, Ophthalmic surgery and lasers.

[15]  Y I Choi,et al.  Corneal flap dimensions in laser in situ keratomileusis using the Innovatome automatic microkeratome. , 2000, Korean journal of ophthalmology : KJO.

[16]  D. Durrie,et al.  Femtosecond laser versus mechanical keratome flaps in wavefront‐guided laser in situ keratomileusis: Prospective contralateral eye study , 2005, Journal of cataract and refractive surgery.

[17]  P. Binder,et al.  Estimating residual stromal thickness before and after laser in situ keratomileusis , 2003, Journal of cataract and refractive surgery.

[18]  R. Duffey,et al.  Thin flap laser in situ keratomileusis: Flap dimensions with the Moria LSK‐One manual microkeratome using the 100‐μm head , 2005, Journal of cataract and refractive surgery.

[19]  B. Seitz,et al.  Evaluation of corneal flap dimensions and cut quality using the SKBM automated microkeratome , 2003, Journal of cataract and refractive surgery.

[20]  H. Bleckmann,et al.  Comparison of 3 microkeratomes used for keratomileusis in situ in a swine model. , 1999, Journal of cataract and refractive surgery.

[21]  J. Rowsey,et al.  Refractive corneal surgery with the Draeger rotary microkeratome in human cadaver eyes. , 1994, Journal of refractive and corneal surgery.

[22]  D. Jabs,et al.  The architecture of the corneal stroma , 2001, The British journal of ophthalmology.

[23]  A. A. Petrov,et al.  Experience with the Nidek MK-2000 microkeratome in 1,220 cases. , 2001, Journal of refractive surgery.

[24]  Perry S Binder,et al.  Flap dimensions created with the IntraLase FS laser , 2004, Journal of cataract and refractive surgery.

[25]  Zsolt Bor,et al.  Randomized prospective clinical study comparing induced aberrations with IntraLase and Hansatome flap creation in fellow eyes: Potential impact on wavefront‐guided laser in situ keratomileusis , 2005, Journal of cataract and refractive surgery.

[26]  E. Slate,et al.  Flap thickness accuracy: Comparison of 6 microkeratome models , 2004, Journal of cataract and refractive surgery.

[27]  S. Necozione,et al.  Flap measurements with the Hansatome microkeratome. , 2002, Journal of refractive surgery.

[28]  P. Binder,et al.  Transient light sensitivity after femtosecond laser flap creation: Clinical findings and management , 2006, Journal of cataract and refractive surgery.