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Laser in situ keratomileusis flap-thickness predictability with a pendular microkeratome
Eleftherios I Paschalis1, Georgios Labiris, Antonis P Aristeidou
1Department of Ophthalmology & Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece. epaschalis@hotmail.com
Journal of Cataract and Refractive Surgery
|October 15, 2011
Summary
This study found that preoperative central corneal thickness (CCT) was the only factor predicting flap thickness in laser in situ keratomileusis. Achieving consistent flap thickness required a learning curve of approximately 100 procedures.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Refractive Surgery
Background:
- Laser in situ keratomileusis (LASIK) is a common refractive surgery procedure.
- Accurate flap creation is crucial for successful LASIK outcomes.
- The Carriazo-Müller microkeratome is used for flap creation, with a 130 μm head setting.
Purpose of the Study:
- To evaluate the predictability of flap thickness using a 130 μm head pendular microkeratome.
- To identify factors influencing flap thickness during LASIK surgery.
Main Methods:
- A clinical trial involving 263 eyes from 132 patients undergoing LASIK.
- Flap thickness, diameter, and shape were assessed using a 130 μm head pendular microkeratome.
- Ultrasound pachymetry measured central corneal thickness (CCT); topography measured keratometry (K).
Main Results:
- Mean flap thickness was 119.2 ± 22.8 μm, significantly less than the 130 μm head setting.
- Flap thickness correlated with preoperative CCT (r=0.271, P<.001) but not K values or manifest refraction.
- Second eyes had thinner flaps, suggesting potential blade dulling; flap thickness stabilized after ~100 cuts.
Conclusions:
- Preoperative CCT is the primary determinant of flap thickness predictability.
- Achieved flap thickness is consistently below the microkeratome head setting.
- A learning curve of approximately 100 flaps is needed for consistent results, with potential blade deterioration affecting sequential cuts.
