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Evaluation of the Intralase Femtosecond Laser Efficiency in LASIK Flap Creation. Mounir A. Khalifa, MD Michael Rizman, MD. Waleed Allam, MD No financial interest for all authors.
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Evaluation of the Intralase Femtosecond Laser Efficiency in LASIK Flap Creation Mounir A. Khalifa, MD Michael Rizman, MD. Waleed Allam, MD No financial interest for all authors
This study aimed at evaluation of the visual and refractive outcomes of wavefront-guided LASIK using the IntraLase femtosecond laser for flap creation. • The study was conducted at Tufts University School of Medicine, Boston, Massachusetts, USA and included 117 eyes of 63 patients with myopia with or without astigmatism.
Intraoperative findings • Achieved flap thickness and diameter:
Intraoperative findings • Pearson simple linear correlation coefficients: *P=0.855>0.05 No correlation between flap thickness and K-reading
Intraoperative findings • Pearson simple linear correlation coefficients: *P=0.866>0.05 No correlation between flap thickness and preoperative corneal thickness
Intraoperative findings • Pearson simple linear correlation coefficients: *P=0.610>0.05 No correlation between flap diameter and K-reading
Intraoperative complications 7.8% intraoperative complication rate.
Early postoperative findings • 114 eyes, out of 117, were available for postoperative follow-up. • At the first postoperative day, the mean LogMAR UCVA was 0.03 ± 0.11 (mean around 20/22). • At the first postoperative day, the peripheral host epithelium defects were noticed in 2 eyes (1.7%) and fine microstriae in one eye (0.9%). • None of the eyes developed interface inflammation or diffuse lamellar keratitis (DLK). • None of the eyes developed remarkable transient light sensitivity syndrome (TLSS).
Late visual and refractive outcomes safetySafety index (postop to preop BCVA) at 1,3, and 6 months = 1.1. Changes in BCVA in terms of Snellen’s lines.
Late visual and refractive outcomes (Efficacy)Efficacy index (postop UCVA to preop BCVA) at 1,3, and 6 months = 1.0. Time course of logMAR UCVA at 1,3, and 6 months.
Late visual and refractive outcomes Efficacy- Total rms # Sig. increase at 1 m. # Non-sig. increase at 3 m. # Back to the 1 m level at 6 m.
Late visual and refractive outcomes Predictability- Attempted vs achieved correction at 6 m
Late visual and refractive outcomes Safety • Visante OCT high resolution corneal scan obtained at 6 months postop.
Conclusions • In this study, IntraLase was proved to be a safe, efficient, and a highly predictable means of LASIK flap creation. • The IntraLase femtosecond laser has significantly reduced the incidence of LASIK flap complications. In addition to that reduction, IntraLase flap complications are much easier to manage than those of the mechanical microkeratome. Accordingly, IntraLase is becoming recognized as a safer method of flap creation. • Its excellent efficacy and predictability with more predictable flap parameters make the IntraLase a very helpful tool in refractive surgery.