In:
Journal of Refractive Surgery, SLACK, Inc., Vol. 21, No. 3 ( 2005-05), p. 253-259
Abstract:
ABSTRACT PURPOSE: To determine the explanatory power of preoperative variables and corneal flap thickness in laser in situ keratomileusis (LASIK) using the Hansatome zero compression microkeratome (Bausch & Lomb, Rochester, NY). METHODS: A prospective, nonrandomized, comparative interventional case study was performed on 250 eyes of 129 consecutive patients who underwent LASIK surgery using the Hansatome zero compression microkeratome. A 160-µm or 180-µm microkeratome head and an 8.5- or 9. 5-mm suction ring were used in the procedures. Preoperative measurements included refraction, spherical equivalent, keratometry, intraocular pressure, corneal white-to-white, anterior chamber depth, and corneal eccentricity. Corneal thickness was measured intraoperative Iy using ultrasonic pachymetry before and after flap creation, and the difference was taken as flap thickness. Flap diameter was measured with a corneal gauge. Data were analyzed using simple, multiple, stepwise linear and non- 1 inear regression analyses and twotailed t tests. RESULTS: The mean flap thickness was 124±17 µm with the nominal 160-µm head and 142 ±20 µm with the nominal 180-µm head. One third (33%) of the total variation in flap thickness could be accounted for by three preoperative variables: average corneal thickness, spherical equivalent refraction, and choice of 160- or 180-µm microkeratome head. A simple correlation of 0.114 was noted between corneal eccentricity and flap thickness, but this variable did not add significant explanatory power on multiple regression analysis. Linear regression analysis allowed determination of a flap thickness nomogram with a standard error of the estimate of 16.9 µm and a 95% confidence interval of ±33.1. CONCLUSIONS: Corneal thickness is the most systematic predictor of corneal flap thickness using the Hansatome microkeratome. Because three preoperative variables account for only 33% of the range in flap thickness, future studies should focus on variations in blade extension and corneal biomechanical factors, which may also play an important role in determining flap thickness. [J Refract Surg. 2005;21:253-259.]
Type of Medium:
Online Resource
ISSN:
1081-597X
DOI:
10.3928/1081-597X-20050501-08
Language:
English
Publisher:
SLACK, Inc.
Publication Date:
2005
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