title: Corneal flap complications in refractive surgery: Part 1: development of an experimental animal model.
abstract: OBJECTIVE
  To report the outcome, learning curve, and complication rates of an experimental animal model for corneal flaps in refractive surgery.
  
  
  METHODS
  Magill Research Center for Vision Correction, Storm Eye Institute, Charleston, South Carolina, USA.
  
  
  METHODS
  Corneal flaps with a nasal or a temporal hinge were created in 190 eyes of 95 Dutch Belted rabbits using the Automated Corneal Shaper microkeratome (Bausch & Lomb Surgical). Diffuse lamellar keratitis (DLK) was induced by inoculating the corneal interfaces with 1 of 7 substances. Postoperatively, the eyes were examined with a slitlamp. Special emphasis was placed on corneal flap complications and the relationship between slipped flaps and hinge position and/or inoculation agent.
  
  
  RESULTS
  A good corneal flap was achieved in 174 eyes (92%). The eyes with a nasal hinge had a lower incidence of slipped flaps (14%) than eyes with a temporal hinge (37%) (P =.02).
  
  
  CONCLUSIONS
  With the animal model described, corneal flaps were created in a precise and reproducible way in more than 90% of eyes. Nasal hinged flaps showed less postoperative displacements than temporal hinged flaps and are adequate for further study.
authors.affiliation: Magill Research Center for Vision Correction, Storm Eye Institute, Medical University of South Carolina, Charleston 29425, USA.
authors.forename: Mike P
authors.initials: MP
authors.lastname: Holzer
authors.forename: Luis G
authors.initials: LG
authors.lastname: Vargas
authors.forename: Helga P
authors.initials: HP
authors.lastname: Sandoval
authors.forename: David T
authors.initials: DT
authors.lastname: Vroman
authors.forename: Terrance J
authors.initials: TJ
authors.lastname: Kasper
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Brown
authors.forename: David J
authors.initials: DJ
authors.lastname: Apple
authors.forename: Kerry D
authors.initials: KD
authors.lastname: Solomon
mesh_terms: D000818:Animals; D003319:Corneal Stroma / Q000601:surgery*; D004195:Disease Models, Animal; D007431:Intraoperative Complications; D007634:Keratitis / Q000209:etiology; D011183:Postoperative Complications; D011817:Rabbits; D054140:Refractive Surgical Procedures; D013524:Surgical Flaps / Q000009:adverse effects*