title: Influence of flap thickness on visual and refractive outcomes after laser in situ keratomileusis performed with a mechanical keratome.
abstract: OBJECTIVE
  To study the effect of flap thickness on visual acuity and refractive outcomes after laser in situ keratomileusis (LASIK) using 2 blade types with a mechanical microkeratome.
  
  
  METHODS
  Emory Vision, Atlanta, Georgia, USA.
  
  
  METHODS
  This retrospective analysis was of LASIK cases performed between January 2005 and June 2006 using an Amadeus I microkeratome and an ML7090 CLB blade (blade A) or a Surepass blade (blade B). Outcomes analyzed included flap thickness, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), the enhancement rate, and surgical complications 3 months postoperatively.
  
  
  RESULTS
  Two hundred sixty-three eyes of 153 patients were analyzed; blade A was used in 158 eyes and blade B, in 105 eyes. The mean flap thickness was significantly thinner with blade A than with blade B (107 microm +/- 12 [SD] versus 130 +/- 20 microm) (P<.0001). There was no overall correlation with either blade between flap thickness and UDVA, CDVA, or MRSE (all r<0.2). At 3 months, there was no statistically significant difference in UDVA, CDVA, or MRSE between the 2 blade groups at 3 months (all P > .10), and there was no difference in the complication rates.
  
  
  CONCLUSIONS
  Flap thickness did not affect visual or refractive outcomes with a mechanical microkeratome with either blade type.
authors.affiliation: Emory Eye Center and Emory Vision, Atlanta, Georgia, USA.
authors.forename: Alok S
authors.initials: AS
authors.lastname: Bansal
authors.forename: Terrence
authors.initials: T
authors.lastname: Doherty
authors.forename: J Bradley
authors.initials: JB
authors.lastname: Randleman
authors.forename: R Doyle
authors.initials: RD
authors.lastname: Stulting
mesh_terms: D000328:Adult; D000368:Aged; D003319:Corneal Stroma / Q000473:pathology*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000473:pathology*; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult
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