TY - JOUR
T1 - In vivo confocal microscopy through-focusing to measure corneal flap thickness after laser in situ keratomileusis
AU - Gokmen, Fusun
AU - Jester, James V.
AU - Petroll, W. Matthew
AU - McCulley, James P.
AU - Cavanagh, H. Dwight
N1 - Funding Information:
Supported in part by Senior Scientist Awards (H.D.C., J.V.J.), the Olga Keith Scholar Award (W.M.P.), and an unrestricted research grant from Research to Prevent Blindness, Inc., New York, New York, USA.
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2002
Y1 - 2002
N2 - Purpose: To measure flap thickness in laser in situ keratomileusis (LASIK) patients using in vivo confocal microscopy through-focusing (CMTF) and compare measured versus intended flap thickness achieved by 2 microkeratomes, the Automated Corneal Shaper® (ACS) (Chiron Bausch & Lomb) and the Hansatome® (Bausch & Lomb). Setting: Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA. Methods: Twenty-seven eyes of 27 patients were examined by in vivo CMTF 3 to 12 months after LASIK was performed with the ACS (12 patients) or Hansatome (15 patients) microkeratome. The central cornea was scanned, and the epithelium, flap, stroma, and total corneal thickness were measured. Normalized flap thickness (NFT) was also calculated to account for changes in epithelial thickness that may have occurred postoperatively. Results: The mean posterior stromal thickness was 341.1 μm ± 53.9 (SD) (range 233 to 431 μm) in the ACS group and 320.3 ± 42.3 μm (range 258 to 382 μm) in the Hansatome group. The mean nonnormalized flap thickness was 132.7 ± 12.5 μm (range 11 to 151 μm) in the ACS group and 167.4 ± 21.4 μm (range 141 to 209 μm) in the Hansatome group. The NFT was 129.6 ± 9.5 μm and 158.4 ± 22.1 μm, respectively. Both microkeratomes cut significantly less than intended (P < .05); however, the ACS cut a thinner-than-intended thickness in all cases, and the Hansatome cut thicker than intended in 13% of cases. The Hansatome also showed significantly greater variability in flap thickness than the ACS (P < .05). Conclusions: A significant difference in precision was noted between the 2 microkeratomes. The findings emphasize the importance of performing thickness measurements and the usefulness of in vivo CMTF in making these determinations to ensure the safety and effectiveness of LASIK.
AB - Purpose: To measure flap thickness in laser in situ keratomileusis (LASIK) patients using in vivo confocal microscopy through-focusing (CMTF) and compare measured versus intended flap thickness achieved by 2 microkeratomes, the Automated Corneal Shaper® (ACS) (Chiron Bausch & Lomb) and the Hansatome® (Bausch & Lomb). Setting: Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA. Methods: Twenty-seven eyes of 27 patients were examined by in vivo CMTF 3 to 12 months after LASIK was performed with the ACS (12 patients) or Hansatome (15 patients) microkeratome. The central cornea was scanned, and the epithelium, flap, stroma, and total corneal thickness were measured. Normalized flap thickness (NFT) was also calculated to account for changes in epithelial thickness that may have occurred postoperatively. Results: The mean posterior stromal thickness was 341.1 μm ± 53.9 (SD) (range 233 to 431 μm) in the ACS group and 320.3 ± 42.3 μm (range 258 to 382 μm) in the Hansatome group. The mean nonnormalized flap thickness was 132.7 ± 12.5 μm (range 11 to 151 μm) in the ACS group and 167.4 ± 21.4 μm (range 141 to 209 μm) in the Hansatome group. The NFT was 129.6 ± 9.5 μm and 158.4 ± 22.1 μm, respectively. Both microkeratomes cut significantly less than intended (P < .05); however, the ACS cut a thinner-than-intended thickness in all cases, and the Hansatome cut thicker than intended in 13% of cases. The Hansatome also showed significantly greater variability in flap thickness than the ACS (P < .05). Conclusions: A significant difference in precision was noted between the 2 microkeratomes. The findings emphasize the importance of performing thickness measurements and the usefulness of in vivo CMTF in making these determinations to ensure the safety and effectiveness of LASIK.
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U2 - 10.1016/S0886-3350(02)01275-0
DO - 10.1016/S0886-3350(02)01275-0
M3 - Article
C2 - 12036637
AN - SCOPUS:0036271439
SN - 0886-3350
VL - 28
SP - 962
EP - 970
JO - Journal of Cataract and Refractive Surgery
JF - Journal of Cataract and Refractive Surgery
IS - 6
ER -