Clinical Safety And Efficacy Of Elliptical Thin-Flap Lasik Using A Low-Pulse Energy Femtosecond Laser

Purpose: To assess the clinical safety and efficacy of elliptical thin-flap LASIK with a low-pulse energy femtosecond laser in 3 thickness subgroups (85, 90, and 100 µm).

Setting: Universal eye center, Zhone-Li, Taiwan

Methods: This retrospective study included case records of 80 patients who underwent bilateral LASIK surgery between April and September 2019. Elliptical corneal flaps with wide temporal hinges and inverted-angled side cuts were created with thicknesses ranging between 80 and 100 µm. Before flap creation, an optical coherence tomography image for visualization of the precut flap position. Postoperative assessments included evaluation of the visual and refractive outcomes, achieved flap thickness dimensions, and intraoperative or postoperative complications.

Results: At postoperative month 1, the overall mean logMAR uncorrected distance visual acuity (UDVA) was −0.04 ± 0.07 (20/18 Snellen) with 96% of eyes achieving UDVA of 20/20 or better. Gain of 1 or more lines of corrected distance visual acuity was seen in 73% of eyes, and 26% of the eyes showed no change. Postoperative mean manifest spherical equivalent was −0.37 ± 0.42 D at 1 month with 69% of eyes showing residual refractive error within ±0.50 D and 91% of eyes showing residual refractive error within ±1.00 D of target correction. Visual and refractive outcomes, when evaluated among the 3 subgroups, were found to be comparable and similar to the overall outcomes. No complications occurred intraoperatively or postoperatively.

Conclusions: OCT-guided, thin-flap LASIK performed with the FEMTO LDV Z8 femtosecond laser was found to be safe and effective and to yield good visual and refractive outcomes.