Comparison of the femtosecond Laser and mechanical microkeratome for flap cutting in LASIK

Abstract

· AIM: To compare refractive results, higher-order aberrations(HOAs), contrast sensitivity and dry eye after laser in situ keratomileusis(LASIK) performed with a femtosecond laser versus a mechanical microkeratome for myopia and astigmatism.·METHODS: In this prospective, non-randomized study,120 eyes with myopia received a LASIK surgery with the Visu Max femtosecond laser for flap cutting, and 120 eyes received a conventional LASIK surgery with a mechanical microkeratome. Flap thickness, visual acuity, manifest refraction, contrast sensitivity function(CSF) curves,HOAs and dry-eye were measured at 1wk; 1, 3, 6mo after surgery.·RESULTS: At 6mo postoperatively, the mean central flap thickness in femtosecond laser procedure was113.05 ±5.89 μm(attempted thickness 110 μm), and148.36 ±21.24 μm(attempted thickness 140 μm) in mechanical microkeratome procedure. An uncorrected distance visual acuity(UDVA) of 4.9 or better was obtained in more than 98% of eyes treated by both methods, a gain in log MAR lines of corrected distance visual acuity(CDVA) occurred in more than 70% of eyes treated by both methods, and no eye lost ≥1 lines of CDVA in both groups. The difference of the mean UDVA and CDVA between two groups at any time post-surgery were not statistically significant(P >0.05). The postoperative changes of spherical equivalent occurred markedly during the first month in both groups. The total root mean square values of HOAs and spherical aberrations in the femtosecond treated eyes were markedly less than those in the microkeratome treated eyes during 6mo visit after surgery(P <0.01). The CSF values of the femtosecond treated eyes were also higherthan those of the microkeratome treated eyes at all space frequency(P <0.01). The mean ocular surface disease index scores in both groups were increased at 1wk, and recovered to preoperative level at 1mo after surgery. The mean tear breakup time(TBUT) of the femtosecond treated eyes were markedly longer than those of the microkeratome treated eyes at postop