title: Comparison of flap adhesion strength using the Amadeus microkeratome and the IntraLase iFS femtosecond laser in rabbits.
abstract: To compare adhesion strength of flaps created with a mechanical microkeratome and the IntraLase femtosecond laser as well as to analyze the effect of different side-cut configurations.
  
  
  
  A flap was created in four groups of New Zealand white rabbits--microkeratome group (Amadeus II microkeratome, Ziemer Group AG [5 eyes; 9-mm suction ring and 140-microm head]), and three IntraLase groups (IntraLase iFS 150 kHz femtosecond laser, AMO Inc [9-mm diameter and 120-microm flap each]): normal energy side-cut (4 eyes; side-cut angle 70 degrees, side-cut energy 0.8 microJ); high energy side-cut (4 eyes; side-cut angle 70 degrees, side-cut energy 1.6 microJ); and inverted side-cut (4 eyes; side-cut angle 140 degrees, side-cut energy 0.8 microJ). Flap adhesion strength was measured 75 days after surgery using a tension meter to dehisce the flaps.
  
  
  
  In the microkeratome group, mean force was 210+/-89 g (range: 151 to 360 g); 492+/-46 g (range: 439 to 540 g) in the normal energy side-cut group; 444+/-13 g (range: 426 to 455 g) in the high energy side-cut group; and 687+/-105 g (range: 552 to 797 g) in the inverted side-cut group. Differences between the microkeratome and all IntraLase groups were highly significant (P=.001), and differences between the inverted side-cut group and the standard 70 degrees side-cut groups were statistically significant (P=.01).
  
  
  
  Flap adhesion is significantly stronger with the IntraLase femtosecond laser than with the Amadeus mechanical microkeratome, and an inverted side-cut increases flap adhesion significantly compared with a standard side-cut.
authors.affiliation: FreeVis LASIK Zentrum, Mannheim, Germany. knorz@eyes.de
authors.forename: Michael C
authors.initials: MC
authors.lastname: Knorz
authors.forename: Urs
authors.initials: U
authors.lastname: Vossmerbaeumer
mesh_terms: D000268:Adhesiveness; D000818:Animals; D003319:Corneal Stroma / Q000502:physiology* / Q000601:surgery; D005260:Female; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation / Q000379:methods*; D053685:Laser Therapy; D011817:Rabbits; D013524:Surgical Flaps / Q000502:physiology*; D013529:Surgical Wound Dehiscence / Q000503:physiopathology*; D000267:Tissue Adhesions / Q000503:physiopathology