Influence of flap thickness on visual and refractive outcomes after laser in situ keratomileusis performed with a mechanical keratome

• Authors: Alok S. Bansal, Emory University; Terrence Doherty, Emory University; Bradley Randleman, Emory University; R Doyle Stulting Jr., Emory University
• Journal Title: Journal of Cataract and Refractive Surgery
• Volume: Volume 36, Number 5
• Publisher: Elsevier | 2010-05, Pages 810-813
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.jcrs.2009.12.025
• Subjects: Health Sciences, Opthamology; Health Sciences, Medicine and Surgery

Abstract

Purpose: To study the effect of flap thickness on visual acuity and refractive outcomes after laser in situ keratomileusis (LASIK) using 2 blade types with a mechanical microkeratome. Setting: Emory Vision, Atlanta, Georgia, USA. Methods: This retrospective analysis was of LASIK cases performed between January 2005 and June 2006 using an Amadeus I microkeratome and an ML7090 CLB blade (blade A) or a Surepass blade (blade B). Outcomes analyzed included flap thickness, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), the enhancement rate, and surgical complications 3 months postoperatively. Results: Two hundred sixty-three eyes of 153 patients were analyzed; blade A was used in 158 eyes and blade B, in 105 eyes. The mean flap thickness was significantly thinner with blade A than with blade B (107 μm ± 12 [SD] versus 130 ± 20 μm) (P<.0001). There was no overall correlation with either blade between flap thickness and UDVA, CDVA, or MRSE (all r<0.2). At 3 months, there was no statistically significant difference in UDVA, CDVA, or MRSE between the 2 blade groups at 3 months (all P > .10), and there was no difference in the complication rates. Conclusion: Flap thickness did not affect visual or refractive outcomes with a mechanical micro-keratome with either blade type. Financial Disclaimer: No author has a financial or proprietary interest in any material or method mentioned.