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Corneal flap complications in refractive surgery: Part 1: development of an experimental animal model
Mike P Holzer1, Luis G Vargas, Helga P Sandoval
1Magill Research Center for Vision Correction, Storm Eye Institute, Medical University of South Carolina, Charleston 29425, USA.
Purpose:
To report the outcome, learning curve, and complication rates of an experimental animal model for corneal flaps in refractive surgery.
Setting:
Magill Research Center for Vision Correction, Storm Eye Institute, Charleston, South Carolina, USA.
Methods:
Corneal flaps with a nasal or a temporal hinge were created in 190 eyes of 95 Dutch Belted rabbits using the Automated Corneal Shaper microkeratome (Bausch & Lomb Surgical). Diffuse lamellar keratitis (DLK) was induced by inoculating the corneal interfaces with 1 of 7 substances. Postoperatively, the eyes were examined with a slitlamp. Special emphasis was placed on corneal flap complications and the relationship between slipped flaps and hinge position and/or inoculation agent.
Results:
A good corneal flap was achieved in 174 eyes (92%). The eyes with a nasal hinge had a lower incidence of slipped flaps (14%) than eyes with a temporal hinge (37%) (P =.02).
Conclusion:
With the animal model described, corneal flaps were created in a precise and reproducible way in more than 90% of eyes. Nasal hinged flaps showed less postoperative displacements than temporal hinged flaps and are adequate for further study.