Femtosecond laser flap creation for laser in situ keratomileusis: six-month follow-up of initial U.S. clinical series.
OBJECTIVE
To evaluate clinical performance of a femtosecond laser for flap creation in laser in situ keratomileusis (LASIK).


METHODS
A prospective, consecutive series of 208 eyes (122 patients) undergoing LASIK between June 2000 and November 2000 using a femtosecond laser for creation of the corneal flap were evaluated for the incidence of complications. A subset of 114 patients who underwent myopic procedures and who were followed for 6 months was analyzed using standard outcome measures.


RESULTS
In 4 of 208 eyes (1.9%), suction was lost during the procedure, causing the flap resection to be interrupted. However, in all four of these eyes the procedure was successfully performed 5 to 45 minutes after re-applanation of the eye. No postoperative complications or adverse events were observed in any treated eye. In the subgroup of 96 eyes undergoing plano correction and followed for 6 months (preoperative spherical equivalent refraction range -0.63 to -12.40 D), 98% (94 eyes) achieved uncorrected visual acuity of 20/40 or better; 94% (90 eyes) achieved 20/30 or better, 79% (76 eyes) achieved 20/25; and 55% (53 eyes) achieved 20/20 or better--all without benefit of retreatment.


CONCLUSIONS
Femtosecond laser corneal flap creation is a safe and effective alternative to traditional mechanical microkeratomes. Standard LASIK nomograms appeared to apply equally well to the all-laser LASIK procedures. The potential for improved flap safety, reproducibility, flexibility, as well as for additional corneal applications are now being explored.
Nordan
Lee T
LT
Scripps Mericos Eye Institute, La Jolla, CA, USA.
Slade
Stephen G
SG
Baker
Richard N
RN
Suarez
Carlos
C
Juhasz
Tibor
T
Kurtz
Ron
R
D003319:Corneal Stroma / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation / Q000379:methods*; D008297:Male; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D012449:Safety; D013524:Surgical Flaps; D016896:Treatment Outcome; D014481:United States; D014792:Visual Acuity