title: Lower intraoperative flap complication rate with the Hansatome microkeratome compared to the Automated Corneal Shaper.
abstract: OBJECTIVE
  The purpose of this study was to retrospectively compare the incidence of intraoperative flap complications, such as partial flaps, donut-shaped flaps, central corneal cuts, and complete caps with the Hansatome and Automated Corneal Shaper (ACS) microkeratomes.
  
  
  METHODS
  All laser in situ keratomileusis (LASIK) procedures performed by a single surgeon with the Hansatome or Automated Corneal Shaper in which intraocular pressure was verified with a pneumotonometer were reviewed.
  
  
  RESULTS
  A total of 90 eyes had LASIK with the ACS microkeratome. Six of the ACS eyes (6.7%) had intraoperative flap complications (4 partial flaps, 1 donut-shaped flap, 0 central corneal cuts, 1 complete cap). Partial flaps and donut-shaped flaps were replaced without laser application and the procedure repeated 2 to 3 months later. Two of these eyes lost 2 lines and one lost 1 line of spectacle-corrected visual acuity at 6 months after repeat LASIK. The eye with the donut-shaped flap was treated with transepithelial photorefractive keratectomy (PRK) and had no change in spectacle-corrected visual acuity at 6 months after PRK. The eye with the complete cap had no change in spectacle-corrected visual acuity after laser ablation. Five hundred ninety-eight (598) eyes had LASIK with the Hansatome microkeratome. Two of the Hansatome eyes (0.3%) had a flap complication (1 partial flap and 1 donut-shaped flap). The first eye retained spectacle-corrected visual acuity at 6 months after repeat LASIK. The second eye had transepithelial PRK to eliminate the donut shaped flap with no loss of spectacle-corrected visual acuity at 6 months after surgery. The difference in flap complications between the two procedures was statistically significant (P < .01). There were no flap displacements following surgery in either group.
  
  
  CONCLUSIONS
  Intraoperative flap complications are less likely to occur with the Hansatome microkeratome than with the ACS microkeratome.
authors.affiliation: Department of Ophthalmology, The University of Washington School of Medicine, Seattle 98195-6485, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Walker
authors.forename: S E
authors.initials: SE
authors.lastname: Wilson
mesh_terms: D000328:Adult; D003315:Cornea / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000601:surgery; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer; D009216:Myopia / Q000601:surgery*; D018903:Photorefractive Keratectomy; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps