Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (2): 17-21.doi: 10.6040/j.issn.1673-3770.1.2020.002

Previous Articles     Next Articles

Analysis of the advantages of flaps created with an optical coherence tomography-guided femtosecond laser

ZHANG Jing1,2, TAO Ye1, LI Fusheng1, WANG Shen1, QU Dongyi1, LI Ying3, ZHOU Yuehua1,2   

  1. 1. Beijing Vision Optometry, Beijing 100191, China;
    2. College of Ophthalmology, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, Sichuan, China;
    3. Department of Ophthalmology, Chinese Academy of Medical Sciences / Peking Union Medical College Hospital, Beijing 100730, China
  • Published:2020-04-07

RichHTML

19

PDF (PC)

735

Abstract: Objective To compare the features of corneal flaps created by using an optical coherence tomography(OCT)-guided femtosecond laser and those created by three other femtosecond lasers. Methods Four types of femtosecond laser laser-assisted in situ keratomileusis procedures were performed on 107 patients(200 eyes)with myopia and myopic astigmatism. Patients were divided into four groups of 50: group A, FEMTO LDV Z8 femtosecond laser; group B, Ziemer Crystalline femtosecond laser; group C, Wavelight FS200 femtosecond laser; and group D, Zeiss VisuMax femtosecond laser. Corneal flap thickness was measured and analyzed by RTVue OCT. Results At 1 week postoperatively, the corneal flap thickness in group A was close to the expected value and the variation range was small. The corneal flap thickness in group B was close to the expected value, but the variation range was large. The corneal flap thickness in group C was thin, that of group D was close to the expected value, and the variation ranges of both groups were small. The corneal flaps created by the four femtosecond lasers were regular and uniform in shape, and there was no statistically significant difference between central and peripheral thicknesses(P>0.05). The differences between the corneal flap thickness value and the predicted value of 110 μm among the four groups were obviously different. The results of groups A(3.43±2.81)μm and D(3.13±2.89)μm were obviously better than those of groups B(6.88±4.13)μm and C(5.44±3.62)μm(F=2.397; P=0.018). Conclusion Compared with the Ziemer Crystalline and Wavelight FS200 femtosecond lasers, the OCT-guided femtosecond laser and the Zeiss VisuMax femtosecond laser featured higher accuracy and better predictability.

Key words: Femtosecond laser, Flap thickness, Laser in situ keratomileusis, Optical coherence tomography

CLC Number: 

  • R772.2
[1] Parafita-Fernández A, Teus M. Femtosecond laser in situ keratomileusis flap creation[J]. J Cataract Refract Surg, 2018, 44(10): 1297. doi:10.1016/j.jcrs.2018.07.020.
[2] Parafita-Fernández A, García-Gonzalez M, Katsanos A, et al. Two femtosecond laser LASIK platforms: comparison of evolution of visual acuity, flap thickness, and stromal optical density[J]. Cornea, 2019, 38(1): 98-104. doi:10.1097/ICO.0000000000001784.
[3] Garcia-Gonzalez M, Bouza-Miguens C, Parafita-Fernandez A, et al. Comparison of visual outcomes and flap morphology using 2 femtosecond-laser platforms[J]. J Cataract Refract Surg, 2018, 44(1): 78-84. doi:10.1016/j.jcrs.2017.10.041.
[4] Zheng Y, Zhou YH, Zhang J, et al. Comparison of laser in situ keratomileusis flaps created by 2 femtosecond lasers[J]. Cornea, 2015, 34(3): 328-333. doi:10.1097/ICO.0000000000000361.
[5] Zhang J, Zhou YH, Zhai CB, et al. Comparison of 2 femtosecond lasers for laser in situ keratomileusis flap creation[J]. J Cataract Refract Surg, 2013, 39(6): 922-927. doi:10.1016/j.jcrs.2013.01.042.
[6] Zhou YH, Zhang J, Tian L, et al. Comparison of the Ziemer FEMTO LDV femtosecond laser and Moria M2 mechanical microkeratome[J]. J Refract Surg, 2012, 28(3): 189-194. doi:10.3928/1081597X-20120208-01.
[7] Zhang J, Zhou YH, Zheng Y, et al. Comparison of visual performance recovery after thin-flap LASIK with 4 femtosecond lasers[J]. Int J Ophthalmol, 2017, 10(10): 1566-1572. doi:10.18240/ijo.2017.10.14.
[8] Tomita M, Watabe M, Mita M, et al. Long-term observation and evaluation of femtosecond laser-assisted thin-flap laser in situ keratomileusis in eyes with thin corneas but normal topography[J]. J Cataract Refract Surg, 2014, 40(2): 239-250. doi:10.1016/j.jcrs.2013.07.054.
[9] Izatt JA, Hee MR, Swanson EA, et al. Micrometer-scale resolution imaging of the anterior eye in vivo with optical coherence tomography[J]. Arch Ophthalmol, 1994, 112(12): 1584-1589. doi:10.1001/archopht.1994.01090240090031.
[10] Yu CQ, Manche EE. A comparison of LASIK flap thickness and morphology between the Intralase 60- and 150-kHz femtosecond lasers[J]. J Refract Surg, 2014, 30(12): 827-830. doi:10.3928/1081597X-20141113-04.
[11] Rocha KM, Krueger RR. Spectral-domain optical coherence tomography epithelial and flap thickness mapping in femtosecond laser-assisted in situ keratomileusis[J]. Am J Ophthalmol, 2014, 158(2): 293-301.e1. doi:10.1016/j.ajo.2014.04.012.
[12] Chan C, Saad A, Randleman JB, et al. Analysis of cases and accuracy of 3 risk scoring systems in predicting ectasia after laser in situ keratomileusis[J]. J Cataract Refract Surg, 2018, 44(8): 979-992. doi:10.1016/j.jcrs.2018.05.013.
[13] Flanagan GW, Binder PS. Role of flap thickness in laser in situ keratomileusis enhancement for refractive undercorrection[J]. J Cataract Refract Surg, 2006, 32(7): 1129-1141. doi:10.1016/j.jcrs.2006.01.095.
[14] Zhang Y, Chen YG, Xia YJ. Comparison of corneal flap morphology using AS-OCT in LASIK with the WaveLight FS200 femtosecond laser versus a mechanical microkeratome[J]. J Refract Surg, 2013, 29(5): 320-324. doi:10.3928/1081597X-20130415-03.
[1] ZHU Mingqiong, LI Zheng, LIU Ru, TIAN Tao, PENG Jingli, LYU Qianyi, TAN Huaxia. The application of AI screening system based on OCT/OCTA in the evaluation of the effect of anti VEGF treatment in patients with diabetes macular edema [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(1): 68-73.
[2] LI Shiqiang, MA Yan, WANG Jiawei. Advances in clinical applications of optical coherence tomography angiography in systemic diseases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(1): 127-134.
[3] CHEN Tao, JIANG Yang, LI Ying. SMILE correction of refractive regression after PRK surgery: a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 148-153.
[4] ZHANG Lu, WANG Yongjing, JIA Jun, ZHAO Jiannan, ZHAO Fang. Spectral domain optical coherence tomography imaging characteristics in patients with initial onset floaters [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 85-88.
[5] HUANG Jiao, PENG Changfu. Progress in objective evaluation of thyroid-related eye disease activity [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(1): 171-178.
[6] MA Jiling, WANG Xiaoming, LI Yan, MU Yanxiao, JIN Lin, KONG Hui, YANG Naifu, DANG Guangfu. Evaluation of three different aspheric intraocular lens tilts and decentrations in capsular bags after cataract surgery based on CASIA2 [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(4): 76-85.
[7] CHANG Weiwei, JIAO Wanzhen, CUI Yanyan, ZHAO Jie, LIU Zhaoqiang, ZHAO Bojun. Research progress of diabetic macular ischaemia [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(3): 130-136.
[8] WU Lili, QU Yi. Application of optical tomography angiography and artificial intelligence in choroidal neovascularization secondary to pathologic myopia [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(2): 144-149.
[9] WANG Xinyu, GAO Lifen, LU Hui, SONG Wenqi, YANG Yu. Related retinal manifestations in Parkinson's disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(2): 156-162.
[10] LIU Jiangchuan, LI Pengwei, GUO Jianqiang, LU Huiqin. Application of optical coherence tomography in idiopathic epiretinal membrane [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(1): 138-142.
[11] YUSUFU·Maierhaba, ABULA·Kelimujiang, DING Lin, QIN Yanli, CHEN Xueyi. Fundus changes in high myopia cataract with posterior scleral staphyloma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(5): 107-114.
[12] ZHANG Xiaohan, WEI Li, YANG Kaili, CHEN Haiyan, LI Yansong, WANG Ping. Study on the change of OCTA and its correlation with visual acuity in patients with CSC before and after TCM syndrome differentiation and treatment [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(5): 115-122.
[13] ZHAO Lu, TIAN Huiwen, MENG Bo, WANG Wei, WANG Yanling. Analysis of macular retinal-choroidal thickness changes in patients with internal carotid artery occlusion [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(3): 72-76.
[14] YOU Ran, GUO Xiaoxiao, WANG Wei, CHEN Xi, WANG Yanling. Association of macular retinoschisis severity with choroidal parameters in patients with high myopia [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(3): 83-87.
[15] ZHAO Hongxiao, ZHANG Han. Effect of optical amplification on measurement of ganglion cell complex [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(1): 105-109.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd