Comparison of DLK incidence after laser in situ keratomileusis associated with two femtosecond lasers: Femto LDV and IntraLase FS60

Abstract

PurposeTo compare the incidence of diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK) with flap creation using the Femto LDV and IntraLase™ FS60 femtosecond lasers.0MethodsA total of 818 consecutive myopic eyes had LASIK performed using either Femto LDV or IntraLase FS60 for flap creation. The same excimer laser, the Allegretto Wave® Eye-Q Laser, was used for correcting refractive errors for all patients. In the preoperative examination, uncorrected distance visual acuity, corrected distance visual acuity, and manifest refraction spherical equivalent were measured. At the postop examination, the same examinations were performed along with a slit-lamp biomicroscopic examination, and patients with DLK were classified into stages. For the statistical analysis of the DLK occurrence rate and the visual and refractive outcomes, the Mann-Whitney’s U-test was used.ResultsIn the Femto LDV group with 514 eyes, 42 (8.17%) had DLK. In the IntraLase FS60 group with 304 eyes, 114 (37.5%) had DLK. There was a statistically significant difference in the DLK incidence rate between these groups (P < 0.0001). Both groups had excellent visual and refractive outcomes. Although low levels of DLK were observed for both groups, they did not affect visual acuity.ConclusionWhile there were significantly fewer incidences of low level DLK when using Femto LDV, neither femtosecond laser induced high levels of DLK, and any postoperative DLK cleared up within 1 week. Therefore, both lasers provide excellent results, with no clinical differences, and both excel at flap creation for LASIK.

Comparison of performances of femtosecond laser and microkeratome for thin‐flap laser in situ keratomileusis

“…The Femto LDV Z6, a newer FDAapproved femtosecond laser system, produced a higher and faster density pulse raster using less energy. Lower energy reduces inflammation resulting in a lower incidence of DLK [29]. Our finding supported the finding that development of fewer LASIK flap complications was correlated negatively with the increased precision of the femtosecond laser system.…”

“…However, the difference did not reach significance, so this only partly explained the differences in the postoperative VA. Previous studies showed femtosecond laser system created more ideal, uniform, and accurate planar LASIK flaps, which resulted in less induced astigmatism, making it more suitable for wavefront‐guided treatments in which small amounts of induced aberrations, especially trefoil, may undermine the outcome of the wavefront treatments . The manifest spherical equivalents in both groups changed slightly within 0.5 D during the 3‐month postoperative period.…”

Comparison of self-reported quality of vision outcomes after myopic LASIK with two femtosecond lasers: a prospective, eye-to-eye study

“…Choe et al14 showed equivalent frequencies of DLK in eyes with flaps made by the FS 15 kHz, FS 30 kHz, and FS 60 kHz systems, but others have shown increased risk of DLK in a comparison between the FS 60 kHz laser and the Femto LDV laser, which has a repetition rate faster than 5 mHz 15. However, Yu and Manche11 reported no instances of DLK in their series, making this possibility moot.…”

Myopic lasik outcomes: comparison of three different femtosecond lasers and a mechanical microkeratome using the same excimer laser

“…TABLE 4 summarizes previous publications that report results with two or more of the microkeratomes that were studied in the current paper 3,4,6-9,17-20, [28][29][30][31][32][33][34] . The disparity of results presented in TABLE 4 can be explained by the fact that numerous parameters (magnitude of ametropia treated, study design, length of follow-up, version of the femtosecond device, excimer laser used, etc.)…”