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Updated: May 19, 2026

Full-Field Optical Coherence Microscopy for Histology-Like Analysis of Stromal Features in Corneal Grafts
Published on: October 21, 2022
Refractive lenticule extraction flap and stromal bed morphology assessment with anterior segment optical coherence
Eugene Tay1, Xiang Li, Cordelia Chan
1Singapore National Eye Centre, Singapore.
Purpose:
To evaluate the flap and stromal bed after refractive lenticule extraction using optical coherence tomography (OCT).
Setting:
Singapore National Eye Centre, Singapore.
Design:
Longitudinal case series.
Methods:
Horizontal scans (RTVue) were taken preoperatively and after refractive lenticule extraction. Two procedures were performed: femtosecond lenticule extraction and small-incision femtosecond lenticule extraction. Flap and bed thicknesses were measured at the center (0.0 mm) and 1.5 mm and 3.0 mm to either side.
Results:
At 1 week, the mean flap at 0.0 mm was borderline thicker (P=.056) and at +3.0 mm significantly thicker after femtosecond lenticule extraction than after small-incision femtosecond lenticule extraction (P=.003). The mean bed at 0.0 mm was thinner after femtosecond lenticule extraction (P=.03). The flap at -3.0 mm showed thinning between 1 week and 3 months after small-incision femtosecond lenticule extraction (P=.018). The flap at +3.0 mm thinned between 1 week and 1 month after femtosecond lenticule extraction (P=.009). After femtosecond lenticule extraction, there were increases in bed (P=.027) and total corneal (P=.013) thicknesses at 0.0 mm between 1 week and 3 months, remaining stable thereafter (3 months: P=.842 and P=.508, respectively). The mean spherical equivalent decreased and the uncorrected acuity improved after both procedures (P<.001), with stabilization of both variables at 3 months.
Conclusion:
A significant difference in stromal bed thickness between femtosecond lenticule extraction and small-incision femtosecond lenticule extraction was detectable by AS-OCT 1 week postoperatively.

