Creation of a Corneal Flap for Laser In Situ Keratomileusis Using a Three-Dimensional Femtosecond Laser Cut: Clinical and Optical Coherence Tomography Features

Antonio Leccisotti, Stefania V. Fields, Giuseppe De Bartolo, Christian Crudale, Matteo Posarelli

Research output: Contribution to journalArticlepeer-review

Abstract

Laser in situ keratomileusis (LASIK) is the most frequently used technique for the surgical correction of refractive errors on the cornea. It entails the creation of a superficial hinged corneal flap using a femtosecond laser, ablation of the underlying stromal bed using an excimer laser, and repositioning of the flap. A corneal flap with an angled side cut reduces the risk of flap dislocation and infiltration of epithelial cells and confers unique biomechanical properties to the cornea. A new laser software creating three-dimensional (3D) flaps using a custom angle side cut was retrospectively evaluated, comparing optical coherence tomography 3D (with intended 90° side cut) and 2D flaps (with tapered side cuts) as well as respective intra- and early postoperative complications. Four hundred consecutive eyes were included, two hundred for each group. In the 3D group, the mean edge angle was 92°, and the procedure was on average 5.2 s slower (p = 0). Non-visually significant flap folds were found in thirteen eyes of the 2D group and in seven eyes of the 3D group (p = 0.17). In conclusion, the creation of a LASIK flap using a 3D femtosecond laser cut, although slightly slower, was safe and effective. The side cut angle was predictable and accurate.
Original languageEnglish
Pages (from-to)267-276
Number of pages10
JournalOptics
Volume5
Issue number2
Early online date10 May 2024
DOIs
Publication statusPublished online - 10 May 2024

Data Access Statement

The raw data supporting the conclusions of this article will be made
available by the authors on request.

Keywords

  • femtosecond laser
  • optical coherence tomography
  • laser in situ keratomileusis

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