Using Femtosecond Laser to Create Customized Corneal Flaps for Patients with Low and Moderate Refractive Error Differing in Corneal Thickness

作者：Zhang, Chi; Che, Jingbin; Yu, Jianhong; Yu, Linli; Yu, Dan; Zhao, Gangping^*

来源：PLos One, 2015, 10(3): e0121291.

DOI：10.1371/journal.pone.0121291

• OPTICAL COHERENCE TOMOGRAPHY
• IN-SITU KERATOMILEUSIS
• STROMAL THICKNESS
• LASIK FLAP
• ANTERIOR SEGMENT
• IATROGENIC KERATECTASIA
• VISUAL PERFORMANCE
• PROBABILITY MODEL
• MICROKERATOME
• REPRODUCIBILITY

This study is designed to evaluate the visual outcomes, accuracy, and predictability of corneal flaps with different thicknesses created by 60-kHz femtosecond laser according to different corneal thicknesses in the patients with low and moderate refractive error. A total of 182 eyes were divided according to the central corneal thickness (470 mu m-499 mu m in Group A, 500 mu m-549 mu m in Group B, and 550 mu m-599 mu m in Group C) and underwent femtosecond laser-assisted LASIK for a target corneal flap thickness (100 mu m for Group A, 110 mu m for Group B, and 120 mu m for Group C). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refractive status were examined. The flap thickness of each eye was measured by anterior segment optical coherence tomography (AS-OCT) on 30 points at 1-month follow-up to assess the accuracy and predictability. Post-operatively, at least 75% of eyes had a UDVA of 20/16 or better, less than 2% of eyes lost one line, over 30% of eyes gained one or more lines in CDVA, at least 95% of eyes had astigmatism of less than 0.25 D, all eyes achieved a correction within +/- 1.00 D from the target spherical equivalent refraction. The visual and refractive outcomes did not differ significantly in all groups (P > 0.05). The mean flap thickness was 100.36 +/- 4.32 mu m (range: 95-113 mu m) in Group A, 111.64 +/- 3.62 mu m (range: 108-125 mu m) in Group B, and 122.32 +/- 2.88 mu m (range: 112-128 mu m) in Group C. The difference at each measured point among the three groups was significant (P < 0.05). The accuracy and predictability were satisfactory in all three groups. In conclusion, this customized treatment yielded satisfactory clinical outcomes with accurate and predictable flap thickness for patients with low and moderate refractive error.

• 出版日期2015-3-25
• 单位佛山市第一人民医院