准分子激光角膜原位磨镶术后主导眼改变及其影响的研究

目的 观察准分子激光原位角膜磨镶术（LASIK）后主导眼分布特点及其影响.方法 前瞻性病例对照研究.选取行LASIK的近视患者190例（380眼）,按屈光参差度数及主导眼眼别分为3组：A组,两眼等效球镜度差异＜1.75 D,共154例;B组,两眼等效球镜差异≥1.75 D,且主导眼为近视度数较高眼,共19例;C组,两眼等效球镜差异≥1.75 D,且主导眼为近视度数较低眼,共17例.术前和术后1个月分别检查裸眼视力、屈光度及确定主导眼（卡洞法）,术后1个月接受远、近视觉满意度问卷调查.组间率的比较采用卡方检验,计量资料采用独立样本t检验.结果 LASIK术前右眼为主导眼125例（65.8%）,左眼65例（34.2%）;术后右眼为主导眼92例（48.4%）,左眼98例（51.6%）.59例（31.1%）患者在术后发生主导眼转变.B组患者中主导眼转变率（47%）高于A组（29%）和C组（29%）（x2=5.38,P＜0.05）.屈光参差患者术前主导眼与非主导眼等效球镜度差异无统计学意义.术后主导眼的等效球镜度为（-0.29±0.89）D,较非主导眼[（-0.42±0.91）D]低,差异存在统计学意义（t=2.448,P=0.015）.主导眼改变和未改变患者的远、近视觉满意度分别为2.33、2.40和3.62、3.95,差异均无统计学意义.结论 LASIK术后存在主导眼的改变,即关键期后,眼优势具有可塑性,尤其在术前有屈光参差且主导眼为近视度数较高眼的患者中发生率更高.术后非主导眼较主导眼更偏近视.但主导眼改变与否对术后视觉满意度无显著影响.     

准分子激光上皮下角膜磨镶术和准分子激光原位角膜磨镶术在屈光回退再治疗的疗效观察

目的比较准份子激光上皮瓣下角膜磨镶术（LASEK）和准分子原位角膜磨镶术（LASIK）在屈光回退再治疗的安全性、有效性和可预测性。方法回顾性分析8例（12只眼）LASEK（A组）和15例（23只眼）LASIK（B组）在术后屈光回退、欠矫再次手术病例。A组采用酒精浸泡保留上皮瓣的方法;B组采用原瓣掀起或再次重新制瓣的方法。结果术后1个月A组眼视力≥0.8者9只眼（占75%）,B组≥0.8者2只眼（87%）,等效球镜屈光度＋1.0～-1.25D之间。B组有1只眼重新制瓣时出现角膜瓣错位,第3次手术行LASEK裸眼视力达到1.0。结论LASEK和LASIK在术后屈光回退、欠矫再治疗是安全有效的。LASIK术后恢复快,层间反应轻,稳定性好,优于LASEK,而LASIK在角膜薄、初次手术瓣异常、高度近视再次手术等选择上优于LASIK。两种手术方法在远期疗效和术后并发症等仍需更长期的观察。     

LASEK与LASIK在屈光回退再治疗比较观察

目的 比较准分子激光上皮瓣下角膜磨镶术(LASEK)和准分子角膜原位磨镶术(LASIK)在矫治屈光回退再治疗的安全性,有效性和可预测性.方法 回顾性分析8例12只眼LASEK(A组)和15例23只眼LASIK(B组)在术后屈光回退,欠矫再次手术病例.A组采用酒精浸泡保留上皮瓣的方法;B组采用原瓣掀起或再次重新制瓣的方法.结果 术后1月A组眼视力≥0.8者9只眼(占75%),B组≥0.8者2只眼(87%),等效球镜屈光度+1.0～-1.25D之间.B组有一例重新制瓣时出现角膜瓣错位,第三次手术行LASEK裸眼视力达到1.0.结论 LASEK和LASIK在术后屈光回退,欠矫再治疗是安全有效的.两种手术方法在远期疗效和术后并发症等仍需更长期的观察.     

飞秒激光与角膜板层刀制瓣激光原位角膜磨镶术后短期视力分析

目的观察飞秒激光制瓣和角膜板层刀制瓣在准分子激光原位角膜磨镶术(LASIK)的临床效果。方法随机抽取我院2015年1~12月LASIK手术患者96例(192只眼),分成两组,其中,飞秒激光(Wave Light FS200)制瓣LASIK组,患者46例(92只眼),Moria M2制瓣的常规LASIK组,患者50例(100只眼)。术前、术后1d、1个月和3个月分别检查记录患者的裸眼视力、矫正视力、屈光度、等效球镜度和术后视力达到或超过术前最佳矫正视力比例。结果两组术后1 d、1个月和3个月视力组间比较差异无统计学意义,各时间点差异无统计学意义(P>0.05);两组术后1 d、1个月和3个月等效球镜组间比较差异无统计学意义,各时间点差异有统计学意义(P<0.05),随着时间增加,等效球镜变小;两组术后1 d、1个月和3个月最佳矫正视力,组间比较差异有统计学意义(P<0.05)。术后1、3个月FS-LASIK组的术后裸眼视力和预定矫正屈光度更好更加稳定,达到或超过术前最佳矫正视力的比例亦高于常规LASIK组,P<0.05。飞秒激光制瓣组术后1个月、3个月达到或超过术前最佳矫正视力分别为84个眼(91.3%)、86只眼(93.5%)。不同时间比较,差异有统计学意义,术后1个月和3个月两组最佳矫正视力比例都比术后1 d要高。结论飞秒激光制瓣LASIK安全精准,并发症轻而少,术后效果优于角膜板层刀LASIK。     

不同切削模式LASIK治疗超高度近视远期疗效

目的探讨不同切削模式LASIK治疗超高度近视(等效球镜度数>-10.00D)的远期疗效及安全性。方法对90例(165只眼)超高度近视根据角膜厚度分为单区切削LASIK及多区LASIK组,术前屈光度数-10.00D～-16.00D平均(-13.2±2.21)D(等效球镜)。A组(单区切削组)32例(59只眼)。平均屈光度为-10D～-12D平均(-11.2±2.21)D(等效球镜)。角膜厚度546～618μm。平均565±23.2μm,平均535μm±21.4μm。术中多区切削为2～3区,切削直径4.5～6μm。单区切削,切削直径为5.75～6.5μm。术后随12访～24个月。结果术后12个月时裸眼视力≥0.5A组49只眼(83%),B组86只眼(81.1%),术后最佳矫正视力A组50只眼(84.7%)B组88只眼(83%),屈光度在±1D以下者两组分别为41只眼(69.4%)72只眼(67.9%),屈光度<±2.00D者两组分别为47只眼(79.6%)82只眼(78.3%),统计学无显著差异。术后两个月内眩光、夜视力下降等并发症以B组为多,3个月左右减轻或消失。屈光回退A组4只眼(6.6%),B组8只眼(7.5%)可能与B组屈光度更高有关。结论对于超高度近视角膜较薄单区切削不够时可选择多区切削模式。多区切削不失为一种有效安全的方法。     

矫正LASIK术后屈光回退手术方式分析

目的：：观察准分子激光原位角膜磨镶术( LASIK)与准分子激光上皮下角膜磨镶术( LASEK)矫正LASIK术后屈光回退的临床疗效。方法：回顾性病例研究。对49例98眼LASIK术后发生屈光回退的患者行二次矫正手术。所有患者分成A、B组,A组24例48眼行LASIK手术,B组25例50眼行LASEK手术,术后1wk;1mo;1a,随访检查视力、屈光度、角膜曲率、总高阶像差值,采用成组t检验进行统计学处理。结果：二次手术后1 wk A、B组视力差异有统计学意义( P<0.05)。术后1 mo 两组视力差异无统计学意义( P>0.05),术后1a A、B组裸眼视力、等效球镜屈光度、平均角膜曲率、总高阶像差值差异均无统计学意义(P>0.05)。LASIK组出现1例角膜上皮增生,LASEK组出现1例2级haze。结论：采用LASIK或LASEK矫正LASIK术后屈光回退均安全、可靠。     

掀瓣行LASIK提升术的临床疗效分析

目的：探讨采用掀瓣行二次准分子激光原位角膜磨镶术(LASIK)治疗LASIK术后欠矫和回退的有效性及安全性。 方法：对LASIK术后因欠矫和屈光回退的近视眼患者25例36眼采用掀开原角膜瓣的方法,对瓣下基质床行再次准分子激光消融。术后随访1a,观察视力、屈光度及手术并发症。 结果：再次术后1,3,6,12mo,平均裸眼视力（UCVA）从术前的0.39±0.16分别提高为0.92±0.17,1.01±0.16,1.03±0.16,1.04±0.18,术前UCVA与术后各时间点比较均具有极显著差异(P<0.01);术前平均等效球镜度数为-1.87±0.64D,术后12mo的等效球镜度数平均为0.21±0.43D,两者比较有极显著性差异(P<0.01)。 结论：采用掀瓣的LASIK提升术治疗LASIK术后欠矫和屈光回退,此方法是安全、有效的。     

LASIK术后5年结果分析

目的 评价准分子激光原位角膜磨镶术（LASIK）治疗近视眼的远期疗效。方法 回顾性系列病例研究。选取LASIK术后随访≥5年资料完整者68例（125眼）,根据术前等效球镜度分为低中度近视组76眼,等效球镜度-0.75～-6.00（-3.79±1.41）D;高度近视组49眼,等效球镜度-6.12～-13.25（-8.13±1.35）D。术后1个月、6个月、1年、5年检查裸眼视力（UCVA）、最佳矫正视力（BCVA）、裂隙灯、角膜地形图和眼底情况,最后一次复查填写满意程度问卷调查表。对数据进行χ2检验、配对样本t检验。结果 低中度近视组和高度近视组术后5年裸眼视力≥0.5的比例分别为100%和96%;术后5年等效球镜度在±1.00 D范围的比例分别为93%和84%;术后最后一次复查最佳矫正视力没有变化或增加的占82%眼（103/125）;术后5年等效球镜度分别为（-0.02±0.65）D和（-0.33±0.80）D,与术后1年比较差异均无统计学意义;1眼术中发生部分游离瓣,1眼术后发生上皮植入,8眼进行了增效手术;两组术后1~5年间均没有出现与手术相关的并发症,患者的满意程度较高。结论 LASIK手术治疗近视术后5年有较好的有效性、安全性和满意度,手术并发症少,术后5年屈光度稳定,远期没有手术相关的并发症发生。     

准分子激光治疗高度和超高度近视的远期疗效

目的:比较准分子激光屈光性角膜切削术(PRK)和激光原位角膜磨镶术(LASIK)治疗高度和超高度近视的远期临床效果及其影响疗效的因素。方法:高度近视眼163例(294眼),其中PRK组84例(139眼),平均等效球镜屈光度-8.68±2.08D,LASIK组79例(155眼),平均等效球镜-9.17±2.92D。按术前屈光度分2组,Ⅰ组-6.25～-10.00D,Ⅱ组≥-10.00D,随访2a。结果:2a时,裸眼视力≥0.5者,Ⅰ组中PRK占89.5%,LASIK占96.8%;Ⅱ组中PRK占35.3%,LASIK占83.9%。裸眼视力≥1.0者,Ⅰ组中PRK为51.4%,LASIK为80.6%;Ⅱ组中PRK为2.9%,LASIK为46.8%。术后屈光度在预期矫正屈光度±1.00D范围以内者:Ⅰ组中PRK为62.8%,LASIK为88.2%;Ⅱ组中PRK为17.6%,LASIK为61.3%。角膜上皮下混浊(Haze)发生率,PRK组0级53.2%,0.5级25.3%,1级13.0%,2级8.6%。其中Ⅰ组发生率为39.0%,Ⅱ组发生率为70.5%。LASIK组均无上皮下或层间混浊发生。术后2a的等效球镜屈光度(Y)PRK组与术前等效球镜(X1雪,角膜屈光力(X 2)建立多元回归方程为Y =-8.645 0.444X1 0.265X 2(P <0.001)。LASIK组与术前等效球镜(X 1)、术中角膜切削深度(X 3)建立多元回归方程Y =-0.703 0.52X 1 0.0437X 3(P <0.001)。结论:准分子激光治疗高度和超高度近视眼的临床效果LASIK术式较PRK术式具有明显的优势。     

LASIK与透明晶状体摘除人工晶状体植入术矫正远视的长期观察

目的 比较LASIK与透明晶体摘除人工晶状体植入术矫正远视的长期疗效.方法 将远视屈光性手术后12月以上病人,分为2组:A组:行LASIK矫正远视者110例211只眼,年龄(51.1±8.8)岁,术前等效球镜为(+2.70±1.4)D,预计矫正(+3.20±1.4)D.采用尼德克Ec-5000常规切削.B组:透明晶状体摘除人工晶状体植入术者53例100只眼,平均(54.4±6.5)岁,术前平均等效球镜为(+3.86±1.9)D,预计矫正(+4.27±2.0)D.采用最陡峭方向2～3mm透明角膜切口,超声乳化,折叠型人工晶状体植入.术中均无并发症.观察手术前后的视力、屈光状态、并发症等.结果 A组平均年龄较B组小(P<0.05);B组术前屈光度、预计矫正屈光度均比A组高(P<0.05).A、B两组分别随访(25.49±9.6)月和(24.10±12)月,无差异(P>0.05).A、B两组术后裸眼视力达到20140的分别为93.8%(198只眼)和94%(94只眼);达20/20分别为69.7%(147只眼)和65%(65只眼),差异无显著统计学意义(P>0.05);术后屈光度与目标屈光度误差分别为0.74D和0.17D,A组高于B组(P<0.05);术后A组48只眼发生干眼症等并发症,B组有28只眼后囊轻度混浊等.结论 两种手术长期有效性和安全性均好,相比较,透明晶状体摘除联合人工晶状体植入术的预测性及稳定性优于LASIK.     

Lasik enhancements: a comparison of lifting to recutting the flap

PURPOSE: To compare the visual outcomes and incidence of complications of lifting with recutting the lamellar flap in laser in situ keratomileusis (LASIK) enhancement surgery. DESIGN: Retrospective case-control study. PARTICIPANTS: Two hundred twelve consecutive eyes undergoing a LASIK enhancement procedure at a single surgery location during a 5-year period. METHODS: Charts of participants were obtained and outcome measures obtained. MAIN OUTCOME MEASURES: Uncorrected visual acuity, best-corrected visual acuity, refractive error, complications. RESULTS: Relifting of flaps was performed in 164 of 212 eyes (77.4%), and recutting of flaps was performed in 48 of 212 eyes (22.6%). There were no significant differences in early visual outcomes between the two groups. At 1 year patients had significantly better uncorrected vision if the flap was lifted rather than recut (20/24.7 vs. 20/31.3, P < 0.008). In addition, the flap lift group had a significantly more stable refraction at 1 year than did the recut group (change in spherical equivalent: +0.05 diopters (D) vs. -0.57 D). The incidence of complications did not significantly differ between the two groups. CONCLUSIONS: LASIK enhancement surgery can be performed safely and effectively by either lifting or recutting a flap. Lifting the flap may show better long-term stability of refractive error and uncorrected acuity.     

Recutting the cornea versus lifting the flap: comparison of two enhancement techniques following laser in situ keratomileusis

PURPOSE: To evaluate enhancement techniques following laser in situ keratomileusis (LASIK). METHODS: Recutting was performed on 263 eyes and the flap was lifted in 55 eyes that had LASIK for simple myopia or myopic astigmatism. The time interval between LASIK and retreatment was 340+/-46 days (range, 270 to 892 days) in the recutting group and 215+/-36 days (range, 53 to 617 days) in the flap lifting group. Mean spherical equivalent refraction, refractive cylinder, uncorrected and best spectacle-corrected visual acuity were examined prior to, and 1, 3, and 6 months after retreatment. RESULTS: Seventeen eyes were lost to follow-up in the lifting group and 53 eyes in the recutting group. In the recutting group, mean spherical equivalent refraction improved from -1.48+/-1.25 D to -0.49+/-0.88 D at 6 months. In the flap lifting group, mean spherical equivalent refraction improved from -1.05+/-1.49 D to -0.45+/-0.39 D at 6 months. Refractive cylinder did not change significantly in either group (P = .2). There was a significant increase in uncorrected visual acuity (UCVA) of 6/6 in each group. In the recutting group, UCVA of 6/6 increased from 3.8% to 65.2% at 6 months, and in the lifting group from 3.6% to 71.1% at 6 months. In the recutting group, seven free flaps and three macerated flaps that required removal occurred. One eye in the recutting group and two in the lifting group developed significant epithelial ingrowth. No patient lost more than one line of best spectacle-corrected visual acuity (BSCVA). CONCLUSION: Both procedures were safe, effective, and highly predictable for enhancements, but flap complications may be more likely with recutting.     

Hyperopic laser in situ keratomileusis to treat overcorrected myopic LASIK

PURPOSE: To evaluate the safety and efficacy of hyperopic laser in situ keratomileusis (LASIK) in treating hyperopia caused by overcorrected myopic LASIK and to evaluate a new technique to place the hyperopic treatment after lifting the initial myopic flap. SETTING: Open-access outpatient excimer laser surgical facility. METHODS: A retrospective analysis was performed of 54 eyes in 47 patients who had spherical hyperopic LASIK by 21 surgeons for the treatment of significant hyperopia after overcorrected LASIK for myopia. In 42 eyes, the initial LASIK flaps were lifted and in 12 eyes, new flaps were cut. The mean age of the 25 men (53%) and 22 women (47%) was 48.2 years +/- 8.4 (SD). Outcome measures included refractive error, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and complications. The mean follow-up was 2.97 months. RESULTS: In eyes in which postoperative emmetropia was attempted (n = 45), the mean spherical equivalent improved from +1.21 +/- 0.49 diopters (D) preoperatively to -0.38 +/- 0.50 D postoperatively (P <.001). The mean UCVA improved from 20/38.6 +/- 16.3 to 20/27.4 +/- 9.4 (P <.001). At the last follow-up, 69% of eyes were within +/-0.5 D and 96% were within +/-1.0 D of emmetropia; 42% had a UCVA of 20/20 and 96% had a UCVA of 20/40 or better. No eyes lost 2 or more lines of BSCVA. No vision-threatening complications occurred. Results in patients who had initial flaps lifted and those who had new flaps cut were statistically indistinguishable. On average, achieved hyperopic corrections were 18% greater than intended. CONCLUSION: Hyperopic LASIK was safe, predictable, and effective in the treatment of hyperopia caused by overcorrected myopic LASIK. Results were similar whether the original flap was lifted or a new one was cut.     

三种屈光手术方法治疗屈光不正患者的疗效比较

目的:观察准分子激光原位角膜磨镶术(LASIK)、波前像差引导的LASIK(WF-LASIK)术与飞秒激光小切口角膜基质透镜取出术(SMILE)治疗屈光不正患者的疗效.方法:回顾性分析.选取2020-03/2021-03本院收治的屈光不正患者97例194眼,依据手术方式分为LASIK组28例56眼、WF-LASIK组3...     

Wavefront-guided ablation with Bausch and Lomb Zyoptix for retreatments after laser in situ keratomileusis for myopia

PURPOSE: To evaluate the efficacy of wavefront-guided ablation for treatment of residual refractive error and higher order aberrations after laser in situ keratomileusis (LASIK) for myopia. METHODS: Twenty-one eyes of 13 patients with residual refractive error after myopic LASIK were treated with a wavefront-guided ablation with the Zyoptix technique. In 13 eyes of 8 patients (Group A) we lifted the flap with an epitheliorhexis technique; in 8 eyes of 5 patients (Group B) we cut a new flap with a Hansatome microkeratome. RESULTS: Preoperative root mean square (RMS) values were 1.370 for second order aberrations, 0.382 for total higher order aberrations, 0.273 for third order, 0.243 for fourth order, and 0.052 for fifth order aberrations. Three months postoperatively, RMS values decreased significantly to 0.278 (second order), 0.189 (total higher order), 0.138 (third order), 0.107 (fourth order), and 0.038 (fifth order). Ablation depth was two times greater than needed with a standard Planoscan treatment. Patients in the microkeratome recut group showed a trend toward overcorrection, and residual astigmatism was higher (-0.75 +/- 0.58 D) than in the flap lift group (-0.25 +/- 0.29 D). CONCLUSIONS: Wavefront-guided ablation was an effective method to correct residual refractive error and higher order aberrations after myopic LASIK. Functional and refractive outcomes were better when we lifted the flap than when we recut the flap.     

不同切削中心对近视眼患者LASIK手术疗效的影响

目的:探讨不同切削中心对接受准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)手术近视眼患者视力、屈光度数、视觉质量的影响.方法:将择期LASIK术的近视眼患者80例160眼分为两组,其中36例72眼以视轴角膜反光点(visual axis corneal reflex point,VACRP)为切削中心(VACRP组),44例88眼以瞳孔中心(pupil center,PC)为切削中心(PC组).术前及术后1mo复查裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)、屈光度数及角膜像差[全角膜角膜前表面总高阶像差(HOA)、球面像差(Z40)、垂直彗差(Z3-1)、水平彗差(Z31)],测定切削中心偏移量.结果:两组术后1mo UCVA ≥1.0的几率、BCVA、屈光度数比较,差异无统计学意义(P>0.05);VACRP组散光度数、切削中心偏移量均小于PC组,差异有统计学意义(P<0.05);VACRP组1mo totHOA、totZ40、totZ3-1、totZ31、froHOA、froZ3-1、froZ31、froZ40低于PC组,差异有统计学意义(P<0.05).结论:两种切削中心均可行LASIK手术的近视眼患者均可获得良好的裸眼视力,但以VACRP为切削中心在减小切削中心偏移量、提高术后视觉质量上更具优势.     

准分子激光原位角膜磨镶术中角膜瓣保湿技术

目的：探讨准分子激光原位角膜磨镶术（ｌａｓｅｒ ｉｎ ｓｉｔｕ ｋｅｒａｔｏｍｉｌｅｕｓｉｓ,ＬＡＳＩＫ）中角膜瓣干燥的预防方法。方法：完成角膜瓣制作后常夫将瓣自身反折,将瓣的颞侧缘与瓣的近蒂部平齐,依靠瓣的基质面的微量水份的表面张力吸附折叠。结果：选择双眼接受ＬＡＳＩＫ的患者３０例,右眼为保湿组,左眼为对照组,激光切事后见保湿组无一眼瓣干燥,对照组２６眼瓣干燥,占８６．７％。结论：角膜瓣折叠保湿     

LASIK后严重角膜上皮植入并角膜瓣融解的处理

目的：探讨ＬＡＳＩＫ术后严重角膜上皮内生所致角膜瓣融解缺损的治疗方法。病例和方法：ＬＡＳＩＫ术后经本院确诊为角膜上皮内生合并角膜瓣融解的１２例１３眼,根据角膜瓣厚度及角膜瓣融解的程度,９眼接受翻开角膜瓣清除层间上皮的治疗,３眼行异体角膜磨镶术,１眼去除角膜瓣。结果：翻开角膜瓣清除膜上皮的９眼中,２眼复发,但再次治疗后正常愈全。异体角膜磨镶术组的３眼角膜瓣均正常愈合。去除角膜瓣的１眼角膜上皮正常,但     

Changes in the refractive index of the human corneal stroma during laser in situ keratomileusis. Effects of exposure time and method used to create the flap

PURPOSE: To compare the refractive index and calculated stromal bed hydration lifting the flap before and after photoablation during uneventful laser in situ keratomileusis (LASIK) using a microkeratome (M2, Moria) or a femtosecond laser (IntraLase, IntraLase Corp.) to create the flap. SETTING: Vissum-Instituto de Oftalmológico de Alicante, Alicante, Spain. METHODS: Uneventful LASIK was performed in 76 eyes of 49 patients. Flaps were created using a microkeratome (57 eyes) or a femtosecond laser (19 eyes). On lifting the flap, the refractive index of the stroma was measured using a customized manual Abbé refractometer. The measurement was repeated immediately after photoablation. Treatment time was noted. Hydration was calculated using the Fatt-Harris equation. RESULTS: Before LASIK, the mean refractive index was 1.366+/-0.0049 (SD) in the microkeratome group and 1.374+/-0.0047 in the femtosecond group. After LASIK, it was 1.382+/-0.0066 and 1.391+/-0.0102, respectively. The increase after ablation was statistically significant in both groups (P<.001). The increase in the refractive index linearly correlated with treatment time (microkeratome: r=0.355, P=.007; femtosecond, r=0.506, P=.027). Before photoablation, the refractive index was significantly lower in the microkeratome group than in the femtosecond group (P<.001). There was no significant difference in age between the 2 groups. CONCLUSIONS: Photoablation increased the refractive index of the stroma, and the increase was influenced by treatment time. Hydration of the stroma was 1.8 mgm/mgm greater in the microkeratome group than in the femtosecond laser group.     

Creation of an extremely thin flap using IntraLase femtosecond laser

A 43-year-old woman had laser in situ keratomileusis (LASIK) using the IntraLase femtosecond laser (IntraLASIK) to create 110 microm flaps. Despite uneventful flap formation, the flaps in both eyes were extremely thin, making it difficult to lift them. The flap in the right eye resembled an epi-LASIK epithelial flap. It was lifted uneventfully. The flap in the left eye was stretched and torn on lifting, and the procedure was therefore postponed. After 6 months, the IntraLASIK surgical procedure was repeated in the left eye using a thicker and smaller flap than in the first procedure. Despite the improvements associated with using an IntraLase femtosecond laser, thinner-than-intended corneal flaps can occur. Early recognition of such a flap can prevent further complications.