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Digital analysis in flap parameter accuracy and opaque bubble layer objective assessment in 100 cases of femtosecond laser-assisted LASIK: a novel technique

Session Details

Session Title: Corneal Femtosecond

Session Date/Time: Monday 07/10/2013 | 14:30-16:30

Paper Time: 14:54

Venue: Elicium 1 (First Floor)

First Author: : G.Pamel USA

Co Author(s): :    A. Kanellopoulos   G. Asimellis           

Abstract Details


To determine flap parameter accuracy, opaque bubble layer extent, and skip-line incidence in femtosecond laser assisted LASIK using the Alcon - WaveLight FS200 laser via optoelectronic clinical measurements.

Setting: Eye Institute, Athens, Greece


Images from one hundred and one flaps were automatically recorded during consecutive routine LASIK procedures performed with the Alcon – WaveLight (Fort Worth, TX) FS200 femtosecond laser and the EX500 excimer laser. Digital processing of these images was employed to objectively evaluate the diameter of FS200-created flaps, by comparing planned Vs. achieved and to evaluate incidence and extent (area) of opaque bubble layer (OBL). Data were assessed using paired two-tailed t-tests, coefficient of determination (r2), trend line linearity, bias, and plots of differences against means.


The intended flap diameters were between 8.00 to 9.50 mm. The achieved flap diameters depicted extremely high precise translation, and were on average just -0.16 mm (± 0.04) smaller for the 8.00 mm intended flap diameter, -0.12 mm (± 0.03) smaller for the 8.50 mm, and up +0.06 mm (±0.06) wider for the 9.50 mm flap respectively. With an average flap area 72.4 mm2, the average OBL area was 4.1 ± 4.3 mm2 (Max, 14.34 mm2 , Min 0), corresponding to a 6% OBL-to-flap area. Specifically 80% of the femtosecond created flaps had essentially zero OBL (0 to under 2.7% of the flap area.


FS200 created flaps, in our clinical experience and with this novel highly objective assessment technique, demonstrate both extreme precision and reproducibility. OBL incidence was minimal. ?

Financial Interest:

... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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