Real time intraocular pressure and lamellar corneal flap thickness in keratomileusis.
BACKGROUND
To measure real time intraocular pressure (IOP) during keratomileusis and to determine variability of corneal flap thickness by using different suction ring pressure settings.


METHODS
Eight human cadaver eyes, two groups of four each, were used. The suction ring of the UniversalKeratome was applied to each eye, the same as for a standard automated lamellar keratoplasty (ALK) or laser in situ keratomileusis (LASIK) procedure, to create a lamellar corneal flap. The pressure of the suction ring on each eye was raised to one of two different levels, four eyes to 488 and the remaining four to 600 mm Hg. IOP was continuously recorded by manometer, from application of the suction ring through the end of the passage of the microkeratome. Central corneal thickness was measured, both before and after each procedure.


RESULTS
IOP increased by >90 mm Hg after application of the suction ring at a pressure of either 488 mm Hg or 600 mm Hg. Corneal flaps performed under a suction ring pressure of 488 mm Hg measured 159.98+/-5 microm, whereas flap thickness for the 600-mm Hg group varied 1.4-266.2 microm. Two flaps exhibited irregular configurations.


CONCLUSIONS
Real time IOP can be measured during keratomileusis. The results demonstrated a significant increase in IOP during the procedure. Suction ring pressure setting is an important variable in determining consistent corneal flap thickness during the keratomileusis procedure.
Kasetsuwan
N
N
Doheny Eye Institute and the Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles, USA.
Pangilinan
R T
RT
Moreira
L L
LL
DiMartino
D S
DS
Shah
S S
SS
Schallhorn
S C
SC
McDonnell
P J
PJ
D003315:Cornea / Q000473:pathology* / Q000601:surgery; D006801:Humans; D066298:In Vitro Techniques; D007429:Intraocular Pressure / Q000502:physiology; D020731:Keratomileusis, Laser In Situ; D016343:Monitoring, Intraoperative / Q000379:methods; D009216:Myopia / Q000601:surgery; D015203:Reproducibility of Results; D013524:Surgical Flaps / Q000473:pathology*; D013997:Time Factors; D014065:Tonometry, Ocular / Q000379:methods