Effect of a New Flap-Making Mode with Visumax Femtosecond LaserAssisted LASIK on the Formation of an Opaque Bubble Layer
Shiming Li1 , Xi He1 , Changbin Zhai2 , Li Zhang2 , Yue Wang2 , Xiumei Song2 , Yi Wang1
1 Medical Optometry of Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing 100730, China 2 Refractive Surgery of the Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing 100730, China
Abstract:Objective: To investigate if a new flap-making pattern of Visumax femtosecond laser-assisted laser in situ keratiomileusis (LASIK) could impact the occurrence of an opaque bubble layer (OBL), and to analyze related factors affecting the formation of an OBL. Methods: This was a case-control study. The preoperative medical records and surgical design parameters of 72 patients (128 eyes) who underwent FS-LASIK in the Refractive Surgery Center of the Beijing Tongren Hospital, Capital Medical University, from April to August 2020 were collected. The OBL and its classification were determined by the operation video. The operative eyes were divided into two groups based on the different patterns of flap-making. There were 64 eyes each in the traditional (38 patients) and new pattern (34 patients) groups, of which a new pattern was adopted for the latter group. The baseline data of the two groups were compared, and the incidence of overall OBLs and OBL types in the two groups were counted. A Chi-square test was used to analyze whether there was any difference. In addition, univariate analysis was performed for the two groups, and significance parameters were incorporated into a logistic regression to further analyze the related influencing factors of OBL. Results: Baseline data was balanced between the two groups. The incidence of OBL in the traditional group was significantly higher than that in the new group (44% vs. 16%, χ2 =12.13, P<0.001), and the incidence of hard OBL in the traditional group was significantly higher than that in the new group (28% vs. 0%, χ2 =12.21, P<0.001). Univariate analysis showed a smaller flap thickness to central corneal thickness ratio in the traditional flap-making group (Z=-1.04, P=0.030), while a higher degree of myopia (Z=-2.33, P=0.020) and smaller corneal diameter (Z=-2.64, P=0.010) ratio were risk factors for OBL in the new flap-making group. Logistic regression showed that an increased corneal diameter could reduce the risk of OBL (OR=0.05, 95%CI: 0.03-0.65, P=0.023). Conclusion: A new flap-making pattern with Visumax femtosecond laser-assisted LASIK can reduce the occurrence of an OBL. It is more likely to occur in patients with a smaller flap thickness to central corneal thickness ratio and a smaller corneal diameter
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Shiming Li1,Xi He1,Changbin Zhai2,et al. Effect of a New Flap-Making Mode with Visumax Femtosecond LaserAssisted LASIK on the Formation of an Opaque Bubble Layer. Chinese Journal of Optometry Ophthalmology and Visual science, 2022, 24(6): 410-415. DOI: 10.3760/cma.j.cn115909-20211002-00406
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