Abstract
Abstract: :
Purpose: The prospective, randomised evaluation of the Amadeus (Allergan, CA) and the M2 (Moria, France) microkeratomes in 100 consecutive LASIK procedures. Methods: We evaluated pre- and post-op refraction, wavefront changes (high order aberrations RMSH and coma), flap thickness, diameter and quality as well as complications. Mean follow-up was four months (3-5). Results: 49 eyes were assigned to the Amadeus, and 51 to the M2. Mean values: The mean pre-operative sphere was -4.75D (-1.00 to -12.50) and cylinder -1.25D (-0.25 to -3.75). At 3 months, 87% of the eyes were 20/20, 47% were 20/15, and 32% were 20/10. 100% of eyes were within +/- 1D at three months. Flap Diameter with the Amadeus: 10.8 (+/-0.5)mm, M2: 9.2 (+/-0.5)mm. Flap Thickness with the Amadeus: 155(+/--50) microns, and with the M2: 120(+/-17)microns. Wavefront analysis showed a postoperative increase in coma of only 35% (mean coma of 6% pre-op and 9% post-op). There was a statistical difference in coma-induction and the use of the two microkeratomes in this study (Amadeus 55%, M2 27%). There were three irregular flaps with the Amadeus, 1 with the M2. There were five cases of mild epithelial ingrowth with the Amadeus only. There was a statistical difference in the first post-op day UCVA between the 2 microkeratomes (20/28 with the Amadeus, 20/22 with the M2). No significant complications were noted in this limited group. Conclusions: LASIK utilizing the Wavelight ALLEGRETTO-WAVE laser and any of the two microkeratomes appears to be safe and very effective in correction of myopic astigmatism. Additionally, it appears that the M2 produces a more consistent flap in thickness and may induce less high order aberrations (attributed to the faster surgical pass) and may have a smaller chance for epithelial ingrowth in comparison with the Amadeus (attributed to flap edge contour) in this limited study.
Keywords: refractive surgery: complications • refractive surgery: optical quality • refractive surgery: LASIK