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Lower intraoperative flap complication rate with the Hansatome microkeratome compared to the Automated Corneal Shaper
1Department of Ophthalmology, The University of Washington School of Medicine, Seattle 98195-6485, USA.
Purpose:
The purpose of this study was to retrospectively compare the incidence of intraoperative flap complications, such as partial flaps, donut-shaped flaps, central corneal cuts, and complete caps with the Hansatome and Automated Corneal Shaper (ACS) microkeratomes.
Methods:
All laser in situ keratomileusis (LASIK) procedures performed by a single surgeon with the Hansatome or Automated Corneal Shaper in which intraocular pressure was verified with a pneumotonometer were reviewed.
Results:
A total of 90 eyes had LASIK with the ACS microkeratome. Six of the ACS eyes (6.7%) had intraoperative flap complications (4 partial flaps, 1 donut-shaped flap, 0 central corneal cuts, 1 complete cap). Partial flaps and donut-shaped flaps were replaced without laser application and the procedure repeated 2 to 3 months later. Two of these eyes lost 2 lines and one lost 1 line of spectacle-corrected visual acuity at 6 months after repeat LASIK. The eye with the donut-shaped flap was treated with transepithelial photorefractive keratectomy (PRK) and had no change in spectacle-corrected visual acuity at 6 months after PRK. The eye with the complete cap had no change in spectacle-corrected visual acuity after laser ablation. Five hundred ninety-eight (598) eyes had LASIK with the Hansatome microkeratome. Two of the Hansatome eyes (0.3%) had a flap complication (1 partial flap and 1 donut-shaped flap). The first eye retained spectacle-corrected visual acuity at 6 months after repeat LASIK. The second eye had transepithelial PRK to eliminate the donut shaped flap with no loss of spectacle-corrected visual acuity at 6 months after surgery. The difference in flap complications between the two procedures was statistically significant (P < .01). There were no flap displacements following surgery in either group.
Conclusion:
Intraoperative flap complications are less likely to occur with the Hansatome microkeratome than with the ACS microkeratome.
Insights
The Hansatome microkeratome has a lower incidence of intraoperative flap complications during laser in situ keratomileusis (LASIK) surgery compared to the Automated Corneal Shaper (ACS). This finding is crucial for optimizing LASIK procedure safety and outcomes.
Area of Science:
- Ophthalmology
- Surgical Technology
- Corneal Surgery
Background:
- Laser in situ keratomileusis (LASIK) is a common refractive surgery.
- Microkeratomes are essential tools for creating corneal flaps during LASIK.
- Comparing the safety and efficacy of different microkeratome devices is important for surgical outcomes.
Purpose of the Study:
- To compare the incidence of intraoperative flap complications between the Hansatome and Automated Corneal Shaper (ACS) microkeratomes.
- To evaluate specific flap complications including partial flaps, donut-shaped flaps, central corneal cuts, and complete caps.
Main Methods:
- Retrospective review of LASIK procedures performed by a single surgeon.
- Inclusion criteria: use of Hansatome or ACS microkeratome and pneumotonometer verification of intraocular pressure.
- Data collected on intraoperative flap complications and visual acuity outcomes.
Main Results:
- The Automated Corneal Shaper (ACS) group (90 eyes) had a 6.7% complication rate (4 partial flaps, 1 donut-shaped flap, 1 complete cap).
- The Hansatome group (598 eyes) had a 0.3% complication rate (1 partial flap, 1 donut-shaped flap).
- The difference in flap complication rates was statistically significant (P < .01), with Hansatome showing fewer complications.
Conclusions:
- Intraoperative flap complications are significantly less likely with the Hansatome microkeratome compared to the ACS microkeratome.
- Both devices had no flap displacements post-surgery.
- Management of complications varied, with some requiring repeat procedures or photorefractive keratectomy (PRK).