Purpose: To compare the visual outcomes of LASIK procedures in which flaps were created with a femtosecond laser (IntraLase FS 60Hz, Abbott Medical Optics [AMO]) to procedures in which flaps were created with a mechanical microkeratome (Moria Evo3 One Use-Plus, Moria SA). Methods: A retrospective analysis was performed on 2000 eyes treated in 2008 for low myopia and astigmatism (sphere <−3.00 diopters [D]; cylinder ⩽−0.75 D). The first 1000 consecutive eyes that had LASIK flaps created with a femtosecond laser were compared with the first 1000 consecutive eyes that had flaps created with a mechanical microkeratome. All eyes received wavefront-guided LASIK treatments performed with a VISX S4 IR Advanced CustomVue excimer laser (AMO). Refractive predictability, change in mean spherical equivalent refraction, postoperative uncorrected visual acuity (UCVA), and loss of best spectacle-corrected visual acuity (BSCVA) were compared at 1 day, 1 week, 1 month, and 3 months following surgery. Results: The refractive accuracy was the same for both groups. At all time points measured, the percentage of eyes that achieved a postoperative UCVA of 20/20 or better was significantly higher in the femtosecond laser group than in the mechanical keratome group. Also, a higher percentage of eyes in the femtosecond laser group achieved a postoperative UCVA of 20/16 at 3 months. Finally, a lower percentage of eyes in the femtosecond laser group lost two or more lines of BSCVA at 1 week and 1 month postoperative. Conclusions: Creating LASIK flaps with the femtosecond laser resulted in faster visual recovery and better UCVA. [ J Refract Surg . 2009;25:S668–S671.]

Mesha Tanna describes a case study involving a young lawyer who wanted to stop wearing contact lenses due to lifestyle factors, demonstrating the effectiveness of iDesign Intralase Lasik.

Mesha Tanna and David Teenan review the cornea, how it changes in disease and through ageing, and look at the technique of collagen cross-linking.