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Laser in situ keratomileusis flap complications using mechanical microkeratome versus femtosecond laser:
Majid Moshirfar1, Jeffrey P Gardiner, Joshua A Schliesser
1Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, Utah, USA. majid.moshirfar@hsc.utah.edu
Purpose:
To compare the incidence of flap complications after creation of laser in situ keratomileusis (LASIK) flaps using a zero-compression microkeratome or a femtosecond laser.
Setting:
John A. Moran Eye Center, Department of Ophthalmology, University of Utah, Salt Lake City, Utah, USA.
Design:
Evidence-based manuscript.
Methods:
The flap complication rate was evaluated during the initial 18 months of experience using a zero-compression microkeratome (Hansatome) or a femtosecond laser (IntraLase FS60) for flap creation.
Results:
The flap complication rate was 14.2% in the microkeratome group and 15.2% in the femtosecond laser group (P = .5437). The intraoperative flap complication rate was 5.3% and 2.9%, respectively (P = .0111), and the postoperative flap complication rate, 8.9% and 12.3%, respectively (P = .0201). The most common intraoperative complication in the microkeratome group was major epithelial defect/sloughing; the rate (2.6%) was statistically significantly higher than in the femtosecond laser group (P = .0006). The most common postoperative complication in both groups was diffuse lamellar keratitis (DLK) (6.0%, microkeratome; 10.6%, femtosecond laser) (P = .0002).
Conclusion:
Although the total complication rates between the 2 groups were similar, the microkeratome group had significantly more epithelial defects intraoperatively and the femtosecond laser group had significantly more DLK cases postoperatively.
