title: Moving from a mechanical microkeratome to a femtosecond laser for LASIK to correct astigmatic patients: clinical outcomes of a retrospective, consecutive, comparative study.
abstract: BACKGROUND
  To evaluate outcomes after optimized laser in situ keratomileusis (LASIK) for astigmatism correction with flap created by a mechanical microkeratome or a femtosecond laser.
  
  
  METHODS
  In this retrospective study, a total of 102 eyes of 71 consecutive patients were enrolled undergoing optimized LASIK treatments using the Allegretto laser system (WaveLight Laser Technologie AG, Erlangen, Germany). A mechanical microkeratome for flap creation was used (One Use, Moria®) in 46 eyes (31 patients, spherical equivalent [SE] -4.44 D ± 2.4) and a femtosecond laser was used (LDV, Ziemer®) in 56 eyes (40 patients, spherical equivalent [SE] -3.07 D ± 3.3). The two groups were matched for inclusion criteria and were operated under similar conditions by the same surgeon.
  
  
  RESULTS
  Overall, the preoperative spherical equivalent was -9.5 diopters (D) to +3.37 D; the preoperative manifest astigmatism was between -1.5 D and -3.5 D. At 6 months postoperatively, the mean postoperative uncorrected distance visual acuity (UDVA) was 0.93 ± 0.17 (range 0.4 to 1.2) in the Moria group and 1.0 ± 0.21 (range 0.6 to 1.6) in the Femto group, which was statistically significant (p = 0.003). Comparing the cylinder power there was a statistical difference between the two groups (p = 0.0015).
  
  
  CONCLUSIONS
  This study shows that the method of flap creation has a significant impact on postoperative astigmatism with a significantly better postoperative UDVA in the Femto group. These findings suggest that the femtosecond laser provides a better platform for LASIK treatment of astigmatism than the commonly used microkeratome.
authors: Jules-Gonin Eye Hospital, University of Lausanne, Switzerland.
authors: I
authors: I
authors: Guber
authors: L
authors: L
authors: Moetteli
authors: L
authors: L
authors: Magnin
authors: F
authors: F
authors: Majo
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D058752:Free Tissue Flaps / Q000706:statistics & numerical data*; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000706:statistics & numerical data*; D008297:Male; D008866:Microsurgery / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome