Objective To compare the corneal topography of patients with myopia and astigmatism 3 months after femtosecond lenticule extraction (Flex) and femtosecond laser in situ keratomileusis (FS-LASIK). Methods In this prospective study, 323 myopic eyes of 165 patients with astigmatism who underwent Flex or FS-LASIK from January to September in 2013 in Beijing Tongren Hospital were examined. An independent samples t test was used to compare visual acuity, refraction and corneal topography measurements 3 months after surgery. Results Three months after surgery, uncorrected visual acuities (UCVA) of logMAR in Flex and FS-LASIK were -0.10±0.08 and -0.11±0.10 and best corrected visual acuities (BCVA) were -0.11±0.07 and -0.12±0.07. These measurements were better than the BCVAs before surgery, which were -0.07±0.03 and -0.07±0.04 (t=4.083, 5.594 and 3.458, 6.440, P<0.01). No significant difference in postoperative UCVA was seen between Flex and FS-LASIK (t=-0.811, -1.864, P>0.05). The cutting decentration with Flex (0.29±0.17 mm) was smaller than with FS-LASIK (0.40±0.17 mm), respectively (t=5.662, P<0.01). There was no correlation with spherical equivalent (SE) in Flex (r=0.122, P>0.05), but there was a positive correlation with SE in FS-LASIK (r=0.210, P<0.01). The postoperative surface regularity index (SRI) of Flex was higher than that of FS-LASIK, 0.34±0.25 and 0.22±0.21, respectively (t=-4.627, P<0.01). Conclusion The cutting decentration of Flex is smaller than that of FS-LASIK, however the regularity of the corneal surface after FS-LASIK is better than that of Flex. Both techniques result in satisfactory visual acuity.
Kymionis GD, Kankariya VP, Plaka AD, et al. Femtosecond laser technology in corneal refractive surgery: a review[J]. J Refract Surg,2012,28:912-920.
[2]
Zhou YH, Zhang J, Tian L, et al. Comparison of the Zeimer FEMTO LDV femtosecond laser and Moria M2 mechanical microkeratome[J]. J Refract Surg,2012,28:189-194.
[3]
Dong Z, Zhou X, Wu J, et al. Small incision lenticule extraction (SMILE) and femtosecond laser LASIK: comparison of corneal wound healing and inflammation[J]. Br J Ophthalmol,2014,98:263-269.
[4]
Shah R, Shah S, vogelsang H. All-in-one femtosecond laser refractive surgery[J]. Tech Ophthalmology,2011,9:114-121.
[5]
Ang M, Chaurasia SS, Angunawela RI, et al. Femtosecond lenticule extraction (FLEx): clinical results, interface evaluation, and intraocular pressure variation[J]. Invest Ophthalmol Vis Sci,2012,53:1414-1421.
[6]
Netto MV, Mohan RR, Medeiros FW, et al. Femtosecond laser and microkeratome corneal flaps: comparison of stromal wound healing and inflammation[J]. J Cataract Refract Surg,2007,23:667-676.
[7]
Dupps WJ Jr, Wilson SE. Biomechanics and wound healing in the cornea[J]. Exp Eyes Res,2006,83:709-720.
[8]
Heichel J, Blum M, Duncker GI, et al. Surface quality of porcine corneal lenticules after femtosecond lenticule extraction [J]. Ophthalmic Res,2011,46:107-112.
[9]
Kunert KS, Blum M, Dunker GI, et al. Surface quality of human corneal lenticules after femtosecond laser surgery for myopia comparing different laser parameters[J]. Graefes Arch Clin Exp Ophthalmol,2011,249:1417-1424.
[10]
Lubatschowski H. Overview of commercially available femtosecond lasers in refractive surgery[J]. J Refract Surg,2008,24:S102-107.
[11]
Vestergaard A, Ivarsen A, Asp S, et al. Femtosecond (FS) laser vision correction procedure for moderate to high myopia: a prospective study of ReLEx (®) Flex and comparison with a retrospective study of FS-laser in situ keratomileusis[J]. Acta Ophthalmol,2013,91:355-362.
[12]
Gertnere J, Solomatin I, Sekundo W. Refractive lenticule extraction (ReLEx flex) and wavefront-optimized Femto-LASIK: comparison of contrast sensitivity and high-order aberrations at 1 year[J]. Graefes Arch Clin Exp Ophthalmol,2013,251:1437-1442.
[13]
Blum M, Kunert K, Schröder M, et al. Femtosecond lenticule extraction for the correction of myopia: preliminary 6-month results[J]. Grafes Arch Clin Exp Ophthalmol,2010,248:1019-1027.