Prediction of flap response.
OBJECTIVE
To find predictors of the induced biomechanical and optical effects of lamellar flap creation on the cornea.


METHODS
Optimed Eye and Laser Clinic, Pretoria, South Africa, and the Department of Ophthalmology and Biomedical Engineering Center, The Ohio State University, Columbus, Ohio, and Bausch & Lomb Vision Research Laboratory, Rochester, New York, USA.


METHODS
This prospective study monitored the refractive, wavefront aberration, and corneal topographic changes in 29 eyes of 15 patients for 3 months after the creation of a corneal lamellar flap. The main outcome measures for statistical analysis were refraction, total corneal thickness, residual corneal bed thickness, horizontal white-to-white corneal diameter, horizontal flap diameter, topography data, and wavefront data.


RESULTS
Statistically significant changes were seen in the autorefraction mode. Wavefront data showed significant change in 4 Zernike modes-90/180-degree astigmatism, vertical coma, horizontal coma, and spherical aberration. The topography data indicated the corneal biomechanical response was significantly predicted by stromal bed thickness in the early follow-up period and by total corneal pachymetry and flap diameter in a 2-parameter statistical model in the late follow-up period.


CONCLUSIONS
Uncomplicated lamellar flap creation is responsible for systematic changes in corneal topography and induction of higher-order optical aberrations. Predictors of this response include stromal bed thickness, flap diameter, and total corneal pachymetry.
Potgieter
Frederik J
FJ
Optimed Eye and Laser Clinic, Pretoria, South Africa. dr.potgieter@lasik.co.za
Roberts
Cynthia
C
Cox
Ian G
IG
Mahmoud
Ashraf M
AM
Herderick
Edward E
EE
Roetz
Marlize
M
Steenkamp
Wouter
W
D000328:Adult; D001696:Biomechanical Phenomena; D003315:Cornea / Q000503:physiopathology*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D013524:Surgical Flaps; D014792:Visual Acuity / Q000502:physiology