Laser in situ keratomileusis flap complications using mechanical microkeratome versus femtosecond laser: Retrospective comparison

• Published in: Journal of cataract and refractive surgery Vol. 36; no. 11; pp. 1925 - 1933
• Main Authors: Moshirfar, Majid, MD, Gardiner, Jeffrey P, Schliesser, Joshua A, Espandar, Ladan, MD, Feiz, Vahid, MD, Mifflin, Mark D., MD, Chang, Joann C., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-11-2010; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Corneal Stroma - pathology; Female; Follow-Up Studies; Humans; Incidence; Intraoperative Complications; Keratomileusis, Laser In Situ - instrumentation; Lasers, Excimer - therapeutic use; Male; Medical sciences; Middle Aged; Ophthalmology; Postoperative Complications; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Surgical Flaps - adverse effects; Young Adult; Microkeratome; Keratomileusis; Treatment; Surgery; In situ; Laser; Complication; Ophthalmology; Flap (surgery); Comparative study; Retrospective
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2010.05.027

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. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.