Femtosecond Laser-Assisted LASIK Flap Complications

Santos, Allisson Mário dos; Torricelli, André A. M.; Marino, Gustavo K.; Garcia, Renato; Netto, Marcelo V.; Bechara, Samir Jacob; Wilson, Steven E.

doi:10.3928/1081597x-20151119-01

Cited by 58 publications

(43 citation statements)

References 53 publications

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“…In this study, we had neither free flaps, irregular flaps, decentered flaps, and epithelial defects, nor complications19 such as opaque bubble layer 20. In the IntraLase group, we had only one patient with transient light sensitivity syndrome21,22 and an eye with microstriae.…”

Section: Discussionmentioning

confidence: 99%

Comparison of efficacy, safety, and predictability of laser in situ keratomileusis using two laser suites

Meidani

Tzavara

2016

OPTH

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PurposeThe main aim of this study was to compare the efficacy, safety, and predictability of femtosecond laser-assisted in situ keratomileusis performed by two different laser suites in the treatment of myopia for up to 6 months.MethodsIn this two-site retrospective nonrandomized study, myopic eyes that underwent laser-assisted in situ keratomileusis using IntraLase FS 60 kHz formed group 1 and those using WaveLight FS200 femtosecond laser system formed group 2. Ablation was performed with Visx Star S4 IR and WaveLight EX500 Excimer lasers, respectively, in groups 1 and 2. Both groups were well matched for age, sex, and mean level of preoperative refractive spherical equivalent (MRSE). Uncorrected distance visual acuity, corrected distance visual acuity, and MRSE were evaluated preoperatively and at 1 week, 1 month, and 6 months after treatment.ResultsFifty-six eyes of 28 patients were included in the study. At 6-month follow-up postop, 78.6% of eyes in group 1 and 92.8% of eyes in group 2 achieved an uncorrected distance visual acuity of 20/20 or better (P=0.252). 35.7% and 50% in group 1 and group 2, respectively, gained one line (P=0.179). No eye lost lines of corrected distance visual acuity. Twenty-five eyes in group 1 (92.7%) and 27 eyes in group 2 (96.3%) had MRSE within ±0.5 D in the 6-month follow-up (P>0.999). The mean efficacy index at 6 months was similar in group 1 and group 2 (mean 1.10±0.12 [standard deviation] vs 1.10±0.1) (P=0.799). The mean safety index was similar in group 1 and group 2 (mean 1.10±0.10 [standard deviation] vs 1.10±0.09) (P=0.407). Conclusion: The outcomes were excellent between the two laser suites. There were no significant differences at 6-month follow-up postop between the two laser systems.

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Section: Discussionmentioning

confidence: 99%

Comparison of efficacy, safety, and predictability of laser in situ keratomileusis using two laser suites

Meidani

Tzavara

2016

OPTH

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“…Another study by Na et al [20] found that off-flap epipolis LASIK yielded superior visual recovery and corneal re-epithelialization than epipolis LASIK surgery in the early postoperative period. In addition, femto-LASIK surgery, despite allowing accurate, safe, and predictable in flap creation, occasionally involves either intraoperative or postoperative complications [21]. Hence, in the current study, we clinically compared the visual and refractive outcomes between femto-LASIK and flap-off epipolis LASIK surgery in myopia or myopic astigmatism; however, we found no statistically significant differences in these outcomes for two years between the groups.…”

Section: Discussionmentioning

confidence: 68%

Comparison of Visual Outcomes for Myopia after Refractive Surgery using Femtosecond Laser-assisted and Epipolis LASIK

Piao¹,

Whang

Joo

2020

Preprint

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Background This prospective cohort study clinically evaluated the visual outcomes after refractive surgery for myopia using femtosecond laser-assisted in situ keratomileusis (femto-LASIK) and epipolis LASIK (flap-off). Methods Forty eyes of 27 patients were divided into 2 groups in this prospective cohort study. Femto-LASIK flaps were created using a femtosecond laser; epipolis LASIK flaps (flap-off) were made using and Epi-K TM epikeratome. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction (MR), corneal asphericity (Q-value), and corneal higher-order aberrations (HOAs) were assessed pre- and postoperatively. Results The improvement in LogMAR UDVA after refractive surgery was statistically significant for both groups ( P < 0.001 for all groups); it was significantly improved for femto-LASIK at 1 day and 1 week postoperatively ( P < 0.001, P = 0.019, respectively). In analysis of the front and total corneal HOAs, there were significant differences in spherical aberrations (Z 4,0 ) between the femto-LASIK and flap-off epipolis LASIK groups ( P = 0.016 and P = 0.017, respectively). In analysis of the back corneal HOAs, there were significant differences in vertical coma (Z 3,-1 ) aberration 0.027 ± 0.027 μm (femto-LASIK) and 0.001 ± 0.034 μm (flap-off epipolis LASIK); horizontal secondary astigmatism (Z 4,2 ) aberration -0.008 ± 0.012 μm (femto-LASIK) and 0.007 ± 0.018 μm (flap-off epipolis LASIK); oblique tetrafoil (Z 4,-4 ) aberration -0.008 ± 0.029 μm (femto-LASIK) and 0.015 ± 0.026 μm (flap-off epipolis LASIK), respectively ( P = 0.018, P = 0.007, and P = 0.022, respectively). However, the back corneal HOA changes did not have a significant effect on the total corneal HOA changes. Conclusion Femto-LASIK yielded better early visual outcomes than that by flap-off epipolis LASIK, but there was no significant difference between the outcomes of the 2 procedures 1 week postoperatively.

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“…In addition, femto-LASIK surgery despite the accurate, safety, and predictable in flap creation, occasionally occur complications either intraoperatively or postoperatively. [19] Hence, in the current study, we clinically evaluated the visual and refractive outcomes between femto-LASIK and off-flap epi-LASIK surgery in myopia or myopic astigmatism, however, there were no statistically significant difference in refractive and visual outcomes between femto-LASIK and off-flap epi-LASIK surgery.…”

Section: Discussionmentioning

confidence: 85%

Comparison of Visual Outcomes for Myopia after Refractive Surgery using Femtosecond Laser-assisted and Epipolis LASIK

Piao¹,

Yoo²,

Whang

et al. 2019

Preprint

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Purpose This study was to clinically evaluate the visual outcomes after refractive surgery for myopia using femtosecond laser-assisted in situ keratomileusis (femto-LASIK) and epipolis LASIK (flap-off epi-LASIK). Methods Forty eyes of 27 patients were divided into 2 groups in a retrospective study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction (MR),corneal asphericity (Q-value) and corneal higher-order aberrations (HOAs) were assessed pre- and postoperatively. Results The pre- and postoperative changes in flattest keratometry reading(K1), steepest keratometry reading(K2), central corneal thickness(CCT), and only Q-value of the anterior surface was statistically significant for both groups (femto-LASIK: P=0.014, P=0.03, P<0.001, P=0.001, respectively; epi-LASIK: all P<0.001). The postoperative corneal thickness spatial profile (CTSP) were statistically significant thinner than preoperative CTSP in both procedures (all P<0.05), and the epi-LASIK was significant thinner than femto-LASIK at 6 mm ring of CTSP (P=0.039). The improvement in LogMAR UDVA after refractive surgery was statistically significant for both groups (P<0.001 for all groups); it was significantly improved for femto-LASIK on day 1 and at 1 week postoperatively (P<0.001, P=0.019, respectively). In analysis of corneal HOAs, there were significant reduction of vertical coma aberration and horizontal secondary astigmatism aberration, and induction of spherical aberration in the front corneal HOAs after femto-LASIK (P=0.021, P=0.001, P=0.001, respectively); in the total corneal HOAs changes were the same pattern as the front corneal HOAs (P=0.007, P=0.004, P<0.001, respectively), but in the back corneal HOAs changes, a few significant induction of vertical coma aberration, and reduction of oblique trefoil aberration and oblique tetrafoil aberration (all P<0.05). In flap-off epi-LASIK, there were only significant induction of SA in the front and total corneal HOAs after surgery (all P<0.05); in the back corneal HOAs, a few significant induced horizontal secondary astigmatism aberration and reduced SA aberration (P=0.027, P=0.011, respectively), however, the back corneal HOAs changes were not significant effect on the total corneal HOAs changes. Conclusion Femto-LASIK showed better early visual outcomes than that noted by epi-LASIK, but there was no significant difference between the outcomes of the 2 procedures 1 week postoperatively.

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Femtosecond Laser-Assisted LASIK Flap Complications

Cited by 58 publications

References 53 publications

Comparison of efficacy, safety, and predictability of laser in situ keratomileusis using two laser suites

Comparison of efficacy, safety, and predictability of laser in situ keratomileusis using two laser suites

Comparison of Visual Outcomes for Myopia after Refractive Surgery using Femtosecond Laser-assisted and Epipolis LASIK

Comparison of Visual Outcomes for Myopia after Refractive Surgery using Femtosecond Laser-assisted and Epipolis LASIK

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Femtosecond Laser-Assisted LASIK Flap Complications

Cited by 58 publications

References 53 publications

Comparison of efficacy, safety, and predictability of&nbsp;laser in situ keratomileusis&nbsp;using two laser suites

Comparison of efficacy, safety, and predictability of&nbsp;laser in situ keratomileusis&nbsp;using two laser suites

Comparison of Visual Outcomes for Myopia after Refractive Surgery using Femtosecond Laser-assisted and Epipolis LASIK

Comparison of Visual Outcomes for Myopia after Refractive Surgery using Femtosecond Laser-assisted and Epipolis LASIK

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Comparison of efficacy, safety, and predictability of laser in situ keratomileusis using two laser suites

Comparison of efficacy, safety, and predictability of laser in situ keratomileusis using two laser suites