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J.L. Alio, J. Javaloy, M.T. Vidal, M.E. Mulet, J.L. Rodriguez Prats, J.L. Rodriguez Prats; QUALITY OF THE CUT PERFORMED BY MICROKERATOMES : A MORPHOLOGICAL EVALUATION USING CORNEAL CONFOCAL MICROSCOPY . Invest. Ophthalmol. Vis. Sci. 2004;45(13):194.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To study the quality of the cut created by three microkeratomes using corneal confocal microscopy Methods: Two different studies were conducted: Study 1 and Study 2. Study 1 was a prospective analysis using confocal microscopy examination data from two reference Groups: Group A (control) with 20 non–operated eyes of 20 healthy volunteers, and Group B with 50 eyes of 30 patients operated on with the Bausch & Lomb Automatic Corneal Shaper (ACS) microkeratome. Study 2 was a prospective, randomized, double–masked study in which 40 eyes of 20 patients underwent myopic LASIK by one surgeon. The right and left eyes of each patient were randomly and alternatively assigned to: Group C, flap made with the Hansatome microkeratome or Group D, flap made with the Moria M2. One month postoperatively, flap thickness, particle density, and the subclinical confocal wound healing opacity (confocal WHO) index were evaluated with the corneal confocal microscope. Results: The depth of the cuts made by the three microkeratomes were significantly different (p< 0.001), with the ACS flaps being thinner than the flaps made with the Hansatome or the M2. Particle density at the interface was significantly poorer in the eyes operated with the ACS, but in these cases the WHO index was significantly greater (p<0.001 in both cases). Conclusions: Confocal microscopy is a very useful tool to evaluate the quality of the cut made by different microkeratomes. Overall, the quality of the cut made by the Moria M2 microkeratome is better than that made by the Hansatome or the ACS. Thin flap made by the ACS microkeratome produced a significantly greater WHO index than the thicker flaps created with the other two microkeratomes.
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