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Flap thickness predictability and safety using the automated microkeratome for Sub-Bowman’s Keratomileusis (SBK).

Poster Details

First Author: C.Falcon SPAIN

Co Author(s):                  

Abstract Details

Purpose:

Preoperative corneal thickness, ablation depth and flap thickness determine the thickness of the residual stromal bed, which is very important in the biomechanics of the cornea in order to avoid an iatrogenic complication. The development of the automated mechanical microkeratome for SBK has minimised the variability of the flap, similar to the femtosecond-assisted flap creation. To evaluate the predictability and safety of the automated Moria One Use-Plus SBK(Moria®,Antony,France) microkeratome. Try to identify different parameters that could have a correlation with the flap thickness.To evaluate the quality of the stromal bed and the handling of the flap.

Setting:

Prospective study of 54 consecutive eyes that underwent SBK with Moria One Use-Plus SBK 90-head microkeratome in our Clinic (OPTIMA LASER Eye Clinic, Valencia, Spain).

Methods:

We prospectively studied 54 eyes that underwent SBK with Moria One Use-Plus SBK 90-head microkeratome with speed 2. Two handpieces of the same model of microkeratome were used depending on the surgical session.The preoperative corneal pachymetry and the intraoperative corneal stromal bed pachymetry were measured with the US-1800 Echoscan ultrasound pachymeter (Nidek®,Gamagori,Japan). The flap thickness was calculated by subtraction. The preoperative refraction and keratometry were also analysed in order to find any correlation with the flap thickness. The results of the two handpieces were compared as well. The quality of the stromal bed was also observed.

Results:

The mean preoperative corneal pachymetry was 547.41 μm , standard deviation (sd) 26.84 μm (range between 495 – 590 μm).The mean flap thickness was 88.3 μm, sd 12.08 μm (range 63 -114 μm). No significant correlation between the preoperative corneal thickness and the flap thickness (r 0.075) was found. No significant correlations between the preoperative refraction or keratometry and the flap thickness were observed. No statistical differences in the flap thickness with both handpieces were found (Student’s t-test 0.19). The procedure went uneventfully in all cases. The stromal bed resulted completely smooth and perfect in quality in all cases.

Conclusions:

The mean flap thickness predictability is equivalent to other published results with the same microkeratome and with different femtosecond-assisted flaps as well. The results are slightly thinner than the intended flap thickness. This allows leaving a thicker residual stromal bed which can be considered safer. The handling of the flap is very easy and comfortable even in thinner flaps. The Moria One Use-Plus SBK microkeratome is an excellent device that allows obtaining thin corneal flaps and regular and smooth corneal beds easily, safely and predictably completely comparable to the femtosecond laser. FINANCIAL DISCLOUSRE: NONE

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