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R. Solomon, E. Donnenfeld, H. Perry; Scanning Electron Microscopy Ultrastructural Comparison of 150 kHz Femtosecond Laser Versus Microkeratome LASIK Corneal Flap Creation. Invest. Ophthalmol. Vis. Sci. 2009;50(13):558.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the surface ultra-structural characteristics of lamellar flap specimens created with a microkeratome versus the fifth generation 150 kHz femtosecond laser by scanning electron microscopy (SEM).
Lamellar flaps were performed in sixteen human eye bank eyes with the Amadeus II microkeratome, (Ziemer Ophthalmic Systems AG, Switzerland) and the 150 kHz femtosecond laser (AMO Inc., Irvine, CA) at 140 micron depths. The beds and edges of the corneal specimens were then examined by SEM. Standardized photographs were taken, and the surface and edge characteristics of the corneal specimens were compared.
Irregularities were noted in the cut edge of Bowman’s membrane in the interface of the keratectomy beds with both instruments but were more prominent with the microkeratome. The flap irregularities in the stromal bed were most prominent in tissue remnants, and were most common in corneas cut with the microkeratome. In addition, fine serrations in Bowman’s membrane appeared in the microkeratome flaps.
The microkeratome and femtosecond laser create different morphologic features as they create a lamellar flap. Greater surface regularity is found in the bed of the lamellar keratectomies created with the femtosecond laser.
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