aDepartment of Ophthalmology at University of Sao Paulo bDepartment of Ophthalmology at Federal University of Rio de Janeiro, Sao Paulo, Brazil cMedical University of South Carolina, and Magill Vision Center, Charleston, South Carolina, USA.
Curr Opin Ophthalmol. 2014 Jul;25(4):270-4. doi: 10.1097/ICU.0000000000000070.
To update the knowledge on differences between mechanical microkeratome and femtosecond flaps for laser in-situ keratomileusis (LASIK) in terms of accuracy and complications.
Corneal flaps created with the femtosecond laser present a more planar architecture and provide greater precision in flap diameter and thickness; a more uniform flap thickness across the flap diameter and it allows the surgeon to programme the angulation of the flap periphery. Femtosecond LASIK flaps are classically related to complications derived from a more intense inflammatory response, such as diffuse lamellar keratitis and transient light-sensitivity syndrome. Newer femtosecond models allow for much lower energy delivery to cut the flap, to the point the overall inflammatory response is not significantly different from the microkeratome. The incidence of complications such as epithelial defect and flap dislocations is higher with microkeratome flaps.
This review examines the accuracy and complications of flaps created with femtosecond and microkeratome. Both femtosecond and microkeratome are able to create accurate LASIK flaps. Femtosecond LASIK flaps represent significant improvement in morphology and predictability with implications for safety.
更新关于机械微型角膜刀和飞秒激光角膜刀（LASIK）在准确性和并发症方面的差异的知识。
飞秒激光制作的角膜瓣具有更平坦的结构，并提供更精确的瓣直径和厚度；瓣直径上更均匀的瓣厚度，并允许外科医生编程瓣周边的角度。飞秒 LASIK 瓣通常与更强烈的炎症反应相关的并发症有关，如弥漫性层状角膜炎和短暂光敏感综合征。新型飞秒模型允许以低得多的能量切割瓣，以至于整体炎症反应与微型角膜刀无明显差异。微型角膜刀瓣的上皮缺损和瓣脱位等并发症的发生率更高。
本文综述了飞秒和微型角膜刀制作的瓣的准确性和并发症。飞秒和微型角膜刀都能够制作精确的 LASIK 瓣。飞秒 LASIK 瓣在形态和可预测性方面有显著改善，对安全性有影响。
