Randomized prospective clinical study comparing induced aberrations with IntraLase and Hansatome flap creation in fellow eyes: Potential impact on wavefront-guided laser in situ keratomileusis

Dan B. Tran, Melvin A. Sarayba, Z. Bor, Carrie Garufis, Yi Jing Duh, Charles R. Soltes, Tibor Juhasz, Ron M. Kurtz

Research output: Contribution to journalArticle

188 Citations (Scopus)

Abstract

Purpose: To measure and compare the changes in objective wavefront aberration and subjective manifest refraction after laser in situ keratomileusis (LASIK) flap creation with a mechanical microkeratome and a femtosecond laser. Setting: Private practice refractive surgery center, Irvine, California, USA. Methods: This randomized prospective study comprised 9 patients (18 eyes) treated with a 2-step LASIK procedure: lamellar keratectomy with a Hansatome microkeratome (Bausch & Lomb) or the IntraLase femtosecond laser in fellow eyes followed by non-wavefront-guided (standard) excimer laser treatment with the Technolas 217A (Bausch & Lomb) excimer laser 10 weeks later. Fellow eyes were matched to within 0.75 diopter (D) sphere and 0.50 D cylinder. Patients were followed for 3 months after excimer laser treatment. Preoperative and post-flap creation wavefront aberrometry using a Hartmann-Shack aberrometer and manifest refraction were compared between the 2 groups. The same tests were performed 3 months after excimer laser ablation. Statistically significant changes were seen in defocus wavefront aberrations after Hansatome (P =. 004) and IntraLase (P =. 008) flap creation. A hyperopic shift in manifest refraction was noted in the Hansatome group after the creation of the corneal flap (P =. 04); no statistically significant changes in manifest refraction were seen in the IntraLase group. Results: Statistically significant changes in total higher-order aberrations (HOAs) (trefoil and quadrafoil Zernike terms) were seen after flap creation in the Hansatome group (P =. 02). No significant changes in HOAs were noted after flap creation in the IntraLase group. After the flap was relifted and standard excimer laser ablation was performed, a statistically significant increase in coma occurred in the Hansatome group (P =. 008). Standard refractive outcomes in the 2 groups were similar. Conclusions: The creation of the LASIK flap alone can modify the eye's optical characteristics in low-order aberrations and HOAs. A significant increase in HOAs was seen in the Hansatome group but not in the IntraLase group. This may have significant clinical implications in wavefront-guided LASIK treatments, which are based on measurements made before flap creation.

Original languageEnglish
Pages (from-to)97-105
Number of pages9
JournalJournal of Cataract and Refractive Surgery
Volume31
Issue number1
DOIs
Publication statusPublished - Jan 2005

Fingerprint

Excimer Lasers
Laser In Situ Keratomileusis
Prospective Studies
Laser Therapy
Aberrometry
Lasers
Refractive Surgical Procedures
Private Practice
Coma
Therapeutics
Clinical Studies

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Randomized prospective clinical study comparing induced aberrations with IntraLase and Hansatome flap creation in fellow eyes : Potential impact on wavefront-guided laser in situ keratomileusis. / Tran, Dan B.; Sarayba, Melvin A.; Bor, Z.; Garufis, Carrie; Duh, Yi Jing; Soltes, Charles R.; Juhasz, Tibor; Kurtz, Ron M.

In: Journal of Cataract and Refractive Surgery, Vol. 31, No. 1, 01.2005, p. 97-105.

Research output: Contribution to journalArticle

Tran, Dan B. ; Sarayba, Melvin A. ; Bor, Z. ; Garufis, Carrie ; Duh, Yi Jing ; Soltes, Charles R. ; Juhasz, Tibor ; Kurtz, Ron M. / Randomized prospective clinical study comparing induced aberrations with IntraLase and Hansatome flap creation in fellow eyes : Potential impact on wavefront-guided laser in situ keratomileusis. In: Journal of Cataract and Refractive Surgery. 2005 ; Vol. 31, No. 1. pp. 97-105.
@article{d00345534acb4f77bdb9101e145b2f7e,
title = "Randomized prospective clinical study comparing induced aberrations with IntraLase and Hansatome flap creation in fellow eyes: Potential impact on wavefront-guided laser in situ keratomileusis",
abstract = "Purpose: To measure and compare the changes in objective wavefront aberration and subjective manifest refraction after laser in situ keratomileusis (LASIK) flap creation with a mechanical microkeratome and a femtosecond laser. Setting: Private practice refractive surgery center, Irvine, California, USA. Methods: This randomized prospective study comprised 9 patients (18 eyes) treated with a 2-step LASIK procedure: lamellar keratectomy with a Hansatome microkeratome (Bausch & Lomb) or the IntraLase femtosecond laser in fellow eyes followed by non-wavefront-guided (standard) excimer laser treatment with the Technolas 217A (Bausch & Lomb) excimer laser 10 weeks later. Fellow eyes were matched to within 0.75 diopter (D) sphere and 0.50 D cylinder. Patients were followed for 3 months after excimer laser treatment. Preoperative and post-flap creation wavefront aberrometry using a Hartmann-Shack aberrometer and manifest refraction were compared between the 2 groups. The same tests were performed 3 months after excimer laser ablation. Statistically significant changes were seen in defocus wavefront aberrations after Hansatome (P =. 004) and IntraLase (P =. 008) flap creation. A hyperopic shift in manifest refraction was noted in the Hansatome group after the creation of the corneal flap (P =. 04); no statistically significant changes in manifest refraction were seen in the IntraLase group. Results: Statistically significant changes in total higher-order aberrations (HOAs) (trefoil and quadrafoil Zernike terms) were seen after flap creation in the Hansatome group (P =. 02). No significant changes in HOAs were noted after flap creation in the IntraLase group. After the flap was relifted and standard excimer laser ablation was performed, a statistically significant increase in coma occurred in the Hansatome group (P =. 008). Standard refractive outcomes in the 2 groups were similar. Conclusions: The creation of the LASIK flap alone can modify the eye's optical characteristics in low-order aberrations and HOAs. A significant increase in HOAs was seen in the Hansatome group but not in the IntraLase group. This may have significant clinical implications in wavefront-guided LASIK treatments, which are based on measurements made before flap creation.",
author = "Tran, {Dan B.} and Sarayba, {Melvin A.} and Z. Bor and Carrie Garufis and Duh, {Yi Jing} and Soltes, {Charles R.} and Tibor Juhasz and Kurtz, {Ron M.}",
year = "2005",
month = "1",
doi = "10.1016/j.jcrs.2004.10.037",
language = "English",
volume = "31",
pages = "97--105",
journal = "Journal of Cataract and Refractive Surgery",
issn = "0886-3350",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Randomized prospective clinical study comparing induced aberrations with IntraLase and Hansatome flap creation in fellow eyes

T2 - Potential impact on wavefront-guided laser in situ keratomileusis

AU - Tran, Dan B.

AU - Sarayba, Melvin A.

AU - Bor, Z.

AU - Garufis, Carrie

AU - Duh, Yi Jing

AU - Soltes, Charles R.

AU - Juhasz, Tibor

AU - Kurtz, Ron M.

PY - 2005/1

Y1 - 2005/1

N2 - Purpose: To measure and compare the changes in objective wavefront aberration and subjective manifest refraction after laser in situ keratomileusis (LASIK) flap creation with a mechanical microkeratome and a femtosecond laser. Setting: Private practice refractive surgery center, Irvine, California, USA. Methods: This randomized prospective study comprised 9 patients (18 eyes) treated with a 2-step LASIK procedure: lamellar keratectomy with a Hansatome microkeratome (Bausch & Lomb) or the IntraLase femtosecond laser in fellow eyes followed by non-wavefront-guided (standard) excimer laser treatment with the Technolas 217A (Bausch & Lomb) excimer laser 10 weeks later. Fellow eyes were matched to within 0.75 diopter (D) sphere and 0.50 D cylinder. Patients were followed for 3 months after excimer laser treatment. Preoperative and post-flap creation wavefront aberrometry using a Hartmann-Shack aberrometer and manifest refraction were compared between the 2 groups. The same tests were performed 3 months after excimer laser ablation. Statistically significant changes were seen in defocus wavefront aberrations after Hansatome (P =. 004) and IntraLase (P =. 008) flap creation. A hyperopic shift in manifest refraction was noted in the Hansatome group after the creation of the corneal flap (P =. 04); no statistically significant changes in manifest refraction were seen in the IntraLase group. Results: Statistically significant changes in total higher-order aberrations (HOAs) (trefoil and quadrafoil Zernike terms) were seen after flap creation in the Hansatome group (P =. 02). No significant changes in HOAs were noted after flap creation in the IntraLase group. After the flap was relifted and standard excimer laser ablation was performed, a statistically significant increase in coma occurred in the Hansatome group (P =. 008). Standard refractive outcomes in the 2 groups were similar. Conclusions: The creation of the LASIK flap alone can modify the eye's optical characteristics in low-order aberrations and HOAs. A significant increase in HOAs was seen in the Hansatome group but not in the IntraLase group. This may have significant clinical implications in wavefront-guided LASIK treatments, which are based on measurements made before flap creation.

AB - Purpose: To measure and compare the changes in objective wavefront aberration and subjective manifest refraction after laser in situ keratomileusis (LASIK) flap creation with a mechanical microkeratome and a femtosecond laser. Setting: Private practice refractive surgery center, Irvine, California, USA. Methods: This randomized prospective study comprised 9 patients (18 eyes) treated with a 2-step LASIK procedure: lamellar keratectomy with a Hansatome microkeratome (Bausch & Lomb) or the IntraLase femtosecond laser in fellow eyes followed by non-wavefront-guided (standard) excimer laser treatment with the Technolas 217A (Bausch & Lomb) excimer laser 10 weeks later. Fellow eyes were matched to within 0.75 diopter (D) sphere and 0.50 D cylinder. Patients were followed for 3 months after excimer laser treatment. Preoperative and post-flap creation wavefront aberrometry using a Hartmann-Shack aberrometer and manifest refraction were compared between the 2 groups. The same tests were performed 3 months after excimer laser ablation. Statistically significant changes were seen in defocus wavefront aberrations after Hansatome (P =. 004) and IntraLase (P =. 008) flap creation. A hyperopic shift in manifest refraction was noted in the Hansatome group after the creation of the corneal flap (P =. 04); no statistically significant changes in manifest refraction were seen in the IntraLase group. Results: Statistically significant changes in total higher-order aberrations (HOAs) (trefoil and quadrafoil Zernike terms) were seen after flap creation in the Hansatome group (P =. 02). No significant changes in HOAs were noted after flap creation in the IntraLase group. After the flap was relifted and standard excimer laser ablation was performed, a statistically significant increase in coma occurred in the Hansatome group (P =. 008). Standard refractive outcomes in the 2 groups were similar. Conclusions: The creation of the LASIK flap alone can modify the eye's optical characteristics in low-order aberrations and HOAs. A significant increase in HOAs was seen in the Hansatome group but not in the IntraLase group. This may have significant clinical implications in wavefront-guided LASIK treatments, which are based on measurements made before flap creation.

UR - http://www.scopus.com/inward/record.url?scp=13844305846&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=13844305846&partnerID=8YFLogxK

U2 - 10.1016/j.jcrs.2004.10.037

DO - 10.1016/j.jcrs.2004.10.037

M3 - Article

C2 - 15721701

AN - SCOPUS:13844305846

VL - 31

SP - 97

EP - 105

JO - Journal of Cataract and Refractive Surgery

JF - Journal of Cataract and Refractive Surgery

SN - 0886-3350

IS - 1

ER -