Comparison of the femtosecond laser and mechanical keratome for laser in situ keratomileusis.
OBJECTIVE
To compare clinical outcomes between fellow eyes randomized to femtosecond laser-created flaps (femtosecond group) or mechanical keratome-created flaps (mechanical group) during wavefront-guided laser in situ keratomileusis.


METHODS
Prospective, randomized, comparative clinical study.


METHODS
Efficacy, safety, predictability, stability, changes in corneal optical aberrations, and low-contrast visual acuity before and 1 week and 1, 3, 6, and 12 months after surgery.


RESULTS
Forty-three patients underwent evaluation in this study. One month after surgery, the mean (SD) spherical equivalent was -0.15 (0.30) diopters (D) for the femtosecond group and -0.12 (0.29) D for the mechanical group (differences were not statistically significant). Twelve months after surgery, 39 eyes (98%) in the femtosecond group had uncorrected visual acuity of 20/20 or better compared with 37 (95%) in the mechanical group. The femtosecond group had fewer high-order, spherical, and coma aberrations and more trefoil aberrations than the mechanical group at 1 month (P = .55), 3 months (P = .05), 6 months (P = .33), and 12 months (P = .48) after surgery. At 25% contrast, the femtosecond group had gains at 1 month (P = .01) and 6 months (P = .008) after surgery.


CONCLUSIONS
Twelve months after keratomileusis, clinical outcomes were similar for both groups.
Chan
Annie
A
Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA 94305, USA.
Ou
Judy
J
Manche
Edward E
EE
D000328:Adult; D003319:Corneal Stroma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology