Cornea-sparing laser in situ keratomileusis: ablation on the flap.
OBJECTIVE
To evaluate the safety and efficacy of laser ablation on the flap as a treatment for a refractive error.


METHODS
Laser Sight Centres, Sydney, Australia.


METHODS
In this noncomparative case series, 142 treatments were performed in 98 patients using cornea-sparing laser in situ keratomileusis (LASIK) with ablation of the corneal flap and, in some cases, also the stromal bed for spherical equivalent (SE) refractive errors from -0.50 diopter (D) to -12.38 D. The procedure was performed as a primary treatment in 104 eyes, an initial enhancement in 32 eyes, and a second enhancement in 6 eyes. Data were extracted for analysis by retrospective review of patients' charts.


RESULTS
After LASIK, the mean SE was -0.20 D +/- 0.47 (SD) (range +0.87 to -2.35 D) excluding eyes with monovision. The 6 eyes with monovision had a mean SE of -1.90 D with myopia of -1.70 D (range -1.00 to -3.00 D) and mean astigmatism of -0.37 D (range 0 to -0.75 D). Excluding eyes with monovision, 97% of eyes achieved an uncorrected visual acuity of 6/12 or better and 64% of eyes, better than or equal to 6/6. Ninety-six percent were within +/-1.0 D of the intended correction (SE). The safety index was 1.02 and the efficacy index, 0.8.


CONCLUSIONS
Laser ablation of the corneal flap achieved good visual results and enabled preservation of the posterior corneal stroma. This technique may aid the prevention of corneal keratectasia following LASIK.
Versace
Patrick
P
Laser Sight Centres Australasia, Sydney, Australia. versace@lasik.com.au
Watson
Stephanie L
SL
D000328:Adult; D000368:Aged; D001251:Astigmatism / Q000601:surgery; D003319:Corneal Stroma / Q000601:surgery*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D012189:Retrospective Studies; D012449:Safety; D013524:Surgical Flaps; D014792:Visual Acuity / Q000502:physiology