title: Effect of marking pens on femtosecond laser-assisted flap creation.
abstract: OBJECTIVE
  To compare the ease of the flap lift after central corneal marking with 2 types of marking pens after femtosecond laser-assisted flap creation in laser in situ keratomileusis.
  
  
  METHODS
  Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.
  
  
  METHODS
  Porcine eyes were prepared for flap creation with a femtosecond laser (IntraLase). The eyes were assigned to 1 of 4 groups. After the femtosecond laser treatment, the difficulty of flap lifting the 4 groups was compared.
  
  
  RESULTS
  Twelve porcine eyes, 3 in each group, were evaluated. In the 2 groups in which an oil-based pen was used, the corneal flap could not be lifted. In the 2 groups in which a water-based pen was used, the corneal flap was easily lifted.
  
  
  CONCLUSIONS
  Oil-based ink may reduce the ability of the femtosecond laser to penetrate the cornea. The resultant corneal flap may require aggressive manipulation to be lifted. When used to mark the center of the cornea before flap creation, water-based ink provided greater ease of corneal flap lifting than oil-based ink. Because the marking is located over the center of the pupil, any alteration of the cornea in this area from aggressive flap lifting may result in substantial visual loss. Therefore, the use of an oil-based ink to mark the central cornea must be avoided to prevent traumatic irregularities of the flap stroma.
authors.affiliation: Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ide
authors.forename: George D
authors.initials: GD
authors.lastname: Kymionis
authors.forename: Ashkan M
authors.initials: AM
authors.lastname: Abbey
authors.forename: Sonia H
authors.initials: SH
authors.lastname: Yoo
authors.forename: William W
authors.initials: WW
authors.lastname: Culbertson
authors.forename: Terrence P
authors.initials: TP
authors.lastname: O'Brien
mesh_terms: D000818:Animals; D003319:Corneal Stroma; D007281:Ink; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D013524:Surgical Flaps; D013525:Surgical Instruments; D013552:Swine