Advances in refractive surgery: microkeratome and femtosecond laser flap creation in relation to safety, efficacy, predictability, and biomechanical stability
Advances in refractive surgery: microkeratome and femtosecond laser flap creation in relation to safety, efficacy, predictability, and biomechanical stability
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DOI：
10.1097/01.icu.0000233957.88509.2d
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发表时间：
2006-08-01
影响因子：
3.7
通讯作者：
Stonecipher, Megan
中科院分区：
文献类型：
--
作者：
Stonecipher, Karl;Ignacio, Teresa S.;Stonecipher, Megan
综述目的多年来，角膜瓣制作方法发生了变化，从机械微型角膜刀的演变到IntraLase飞秒激光角膜刀的引入，两者都具有不同的角膜切除作用机制。先前的研究报告了机械角膜刀和IntraLase飞秒激光的优缺点。然而，激光原位角膜磨镶术的关键组成部分保持不变：安全性、有效性、可预测性和生物力学稳定性。最近的发现角膜扩张和角膜瓣效率仍然是激光原位角膜磨镶术的一个恒定的安全问题。出乎意料的厚瓣以及可变厚度仍然是与微型角膜刀技术相关的安全性问题。上皮保护、皮瓣并发症和较新的问题（如一过性光敏感综合征）是皮瓣创建的安全问题。在视力、诱导散光、诱导高阶像差和增强率方面的结局改善有利于飞秒技术的可预测性，优于显微角膜刀。最近的生物力学研究表明，改善愈合与飞秒激光皮瓣创建相比，刀片辅助flap creation.SummaryThe的目的是总结的关键组成部分的微型角膜刀和飞秒激光，并更新对这些主题的最新进展报告。
Purpose of reviewMethods of flap creation have changed over the years from the evolution of the mechanical microkeratome to the introduction of the IntraLase femtosecond laser keratome, both of which have different mechanisms of action to create corneal resections. Previous studies report the advantages and disadvantages of the mechanical microkeratome and the IntraLase femtosecond laser. The critical components in laser in-situ keratomileusis surgery remain the same, however: safety, efficiency, predictability, and biomechanical stability.Recent findingsKeratoectasia and flap efficiency remain a constant safety concern in laser in-situ keratomileusis surgery. Unexpectedly thick flaps as well as variable thickness continue to be a concern with safety in relation to microkeratome technology. Epithelial preservation, flap complications, and newer issues such as Transient Light Sensitivity Syndrome are safety concerns of flap creation. Improved outcomes with regards to vision, induced astigmatism, induced higher-order aberrations, and enhancement rates are seen to favor predictability of femtosecond technologies over the microkeratome. Recent biomechanical studies show improved healing with femtosecond laser flap creation compared with blade-assisted flap creation.SummaryThe aim of this review is to summarize the key components for both the microkeratome and the femtosecond laser and to update on the recent advances reported on these topics.