Thin flap laser in situ keratomileusis: flap dimensions with the Moria LSK-One manual microkeratome using the 100-microm head.
OBJECTIVE
To determine the predictability and consistency of corneal flap thickness, flap diameter, and hinge length with the modern 100 microm head of the Moria LSK-One manual microkeratome.


METHODS
Private clinic, office-based practice.


METHODS
Forty-two consecutive eyes with no previous surgery having thin flap laser in situ keratomileusis with the Moria LSK-One manual microkeratome had a new 100 microm (predicted flap thickness) head used for flap creation. Flap thickness was measured intraoperatively by subtraction ultrasound pachymetry (difference between central corneal thickness before flap cutting and residual stromal bed thickness after flap lifting). Vertical flap diameter and nasal hinge length were measured with calipers.


RESULTS
Mean flap thickness was 107 microm +/- 14 (SD) (range 82 to 137 microm). Standard deviation for mean vertical flap diameter was +/-0.24 mm. The cord length of the nasal hinge was variable with a mean of 4.26 +/- 0.63 mm (range 3.12 to 5.75 mm) in length. Postoperatively, there were no slipped flaps, flap striae, diffuse lamellar keratitis, or epithelial defects; there was 1 epithelial slide. At 1 day, the visual acuity was 20/20 or better in 76% of eyes.


CONCLUSIONS
The 100 microm head of the Moria LSK-One manual microkeratome cut a very predictable flap thickness and diameter but with variable length hinges. This flap thickness predictability was superior to that in other series with thicker intended flaps cut with mechanical microkeratomes and is comparable to that reported with the IntraLase FS femtosecond laser. Visual recovery was rapid, epithelial risks minimal, efficiency superior, and cost nominal relative to femtosecond laser technology.
Duffey
Richard J
RJ
Premiere Medical Eye Group, Mobile, Alabama, USA. duffey@duffeylaser.com
D000328:Adult; D003319:Corneal Stroma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D004108:Dilatation, Pathologic / Q000517:prevention & control; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation* / Q000379:methods; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D013524:Surgical Flaps / Q000473:pathology*; D014463:Ultrasonography; D014792:Visual Acuity / Q000502:physiology