Biomechanical Changes to the Cornea from LASIK Flap Creation Resulting in Inaccurate Ablations and Suboptimal Refractive Outcomes with Topographic-Guided Ablation

Biomechanical Changes to the Cornea from LASIK Flap Creation Resulting in Inaccurate Ablations and Suboptimal Refractive Outcomes with Topographic-Guided Ablation

Manoj Motwani Motwani LASIK Institute, San Diego, CA 92121, USACorrespondence: Manoj MotwaniMotwani LASIK Institute, 4520 Executive Dr., Suite 230, San Diego, CA 92121, USATel +1 858 554-0008Email drmmlj@gmail.comPurpose: This study documents a biomechanical corneal change related to corneal flap cr...

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Autor principal: Motwani M
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2020
Materias:
corneal epithelium
femtosecond laser
higher order aberration
laser ablation
laser in-situ keratomileusis
lasik
Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/3d326ddeec1746c08bcd34c982315559
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spelling oai:doaj.org-article:3d326ddeec1746c08bcd34c9823155592021-12-02T12:31:18ZBiomechanical Changes to the Cornea from LASIK Flap Creation Resulting in Inaccurate Ablations and Suboptimal Refractive Outcomes with Topographic-Guided Ablation1177-5483https://doaj.org/article/3d326ddeec1746c08bcd34c9823155592020-08-01T00:00:00Zhttps://www.dovepress.com/biomechanical-changes-to-the-cornea-from-lasik-flap-creation-resulting-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Manoj Motwani Motwani LASIK Institute, San Diego, CA 92121, USACorrespondence: Manoj MotwaniMotwani LASIK Institute, 4520 Executive Dr., Suite 230, San Diego, CA 92121, USATel +1 858 554-0008Email drmmlj@gmail.comPurpose: This study documents a biomechanical corneal change related to corneal flap creation in certain patients leading to an irregular ablation pattern and an inaccurate refractive outcome.Methods: This retrospective study included consecutive eyes treated with primary LASIK Contoura using the LYRA Protocol. All LASIK procedures were performed on the WaveLight EX500 excimer laser. Flaps were created with either the Alcon WaveLight FS200 femtosecond laser or the Moria M2 microkeratome. Eyes that were off by greater than or equal to 0.50 diopters (D) sphere or cylinder from the targeted goal within 3 months after surgery were identified. Topographical, higher order aberration, and epithelial maps were created. Of these eyes, approximately 10% of eyes were found to have undergone a biomechanical change upon flap creation that led to an inaccurate outcome.Results: Six representative cases are presented that demonstrate the biomechanical change, outcomes, and treatment. All patients demonstrated an elliptical, irregular ablation pattern on post-operative topography, lateralized the thinnest point of the cornea relative to the corneal apex on Pentacam pachymetry maps, and irregular corneal epithelial thickening at the periphery of the elliptical ablation.Conclusion: A biomechanical change during flap creation can occur in certain types of corneas during LASIK flap creation and subsequent treatment with topographic-guided ablation leading to an irregular ablation and suboptimal refractive outcomes.Keywords: corneal epithelium, femtosecond laser, higher order aberration, laser ablation, laser in-situ keratomileusis, LASIKMotwani MDove Medical Pressarticlecorneal epitheliumfemtosecond laserhigher order aberrationlaser ablationlaser in-situ keratomileusislasikOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 2319-2327 (2020)
institution DOAJ
collection DOAJ
language EN
topic corneal epithelium
femtosecond laser
higher order aberration
laser ablation
laser in-situ keratomileusis
lasik
Ophthalmology
RE1-994
spellingShingle corneal epithelium
femtosecond laser
higher order aberration
laser ablation
laser in-situ keratomileusis
lasik
Ophthalmology
RE1-994
Motwani M
Biomechanical Changes to the Cornea from LASIK Flap Creation Resulting in Inaccurate Ablations and Suboptimal Refractive Outcomes with Topographic-Guided Ablation
description Manoj Motwani Motwani LASIK Institute, San Diego, CA 92121, USACorrespondence: Manoj MotwaniMotwani LASIK Institute, 4520 Executive Dr., Suite 230, San Diego, CA 92121, USATel +1 858 554-0008Email drmmlj@gmail.comPurpose: This study documents a biomechanical corneal change related to corneal flap creation in certain patients leading to an irregular ablation pattern and an inaccurate refractive outcome.Methods: This retrospective study included consecutive eyes treated with primary LASIK Contoura using the LYRA Protocol. All LASIK procedures were performed on the WaveLight EX500 excimer laser. Flaps were created with either the Alcon WaveLight FS200 femtosecond laser or the Moria M2 microkeratome. Eyes that were off by greater than or equal to 0.50 diopters (D) sphere or cylinder from the targeted goal within 3 months after surgery were identified. Topographical, higher order aberration, and epithelial maps were created. Of these eyes, approximately 10% of eyes were found to have undergone a biomechanical change upon flap creation that led to an inaccurate outcome.Results: Six representative cases are presented that demonstrate the biomechanical change, outcomes, and treatment. All patients demonstrated an elliptical, irregular ablation pattern on post-operative topography, lateralized the thinnest point of the cornea relative to the corneal apex on Pentacam pachymetry maps, and irregular corneal epithelial thickening at the periphery of the elliptical ablation.Conclusion: A biomechanical change during flap creation can occur in certain types of corneas during LASIK flap creation and subsequent treatment with topographic-guided ablation leading to an irregular ablation and suboptimal refractive outcomes.Keywords: corneal epithelium, femtosecond laser, higher order aberration, laser ablation, laser in-situ keratomileusis, LASIK
format article
author Motwani M
author_facet Motwani M
author_sort Motwani M
title Biomechanical Changes to the Cornea from LASIK Flap Creation Resulting in Inaccurate Ablations and Suboptimal Refractive Outcomes with Topographic-Guided Ablation
title_short Biomechanical Changes to the Cornea from LASIK Flap Creation Resulting in Inaccurate Ablations and Suboptimal Refractive Outcomes with Topographic-Guided Ablation
title_full Biomechanical Changes to the Cornea from LASIK Flap Creation Resulting in Inaccurate Ablations and Suboptimal Refractive Outcomes with Topographic-Guided Ablation
title_fullStr Biomechanical Changes to the Cornea from LASIK Flap Creation Resulting in Inaccurate Ablations and Suboptimal Refractive Outcomes with Topographic-Guided Ablation
title_full_unstemmed Biomechanical Changes to the Cornea from LASIK Flap Creation Resulting in Inaccurate Ablations and Suboptimal Refractive Outcomes with Topographic-Guided Ablation
title_sort biomechanical changes to the cornea from lasik flap creation resulting in inaccurate ablations and suboptimal refractive outcomes with topographic-guided ablation
publisher Dove Medical Press
publishDate 2020
url https://doaj.org/article/3d326ddeec1746c08bcd34c982315559
work_keys_str_mv AT motwanim biomechanicalchangestothecorneafromlasikflapcreationresultingininaccurateablationsandsuboptimalrefractiveoutcomeswithtopographicguidedablation
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