Comparison of Laser in situ Keratomileusis Flap Made by Femtosecond Laser and Mechanical Microkeratome

  Objective  To compare the effect of laser in situ keratomileusis (LASIK) surgery after flap creation with a femtosecond laser and a mechanical microkeratome.

  Methods  Totally 300 eyes of 150 cases after FEMTO LDV femtosecond laser LASIK surgery (F-LASIK group) and 300 eyes of 150 cases after mechanical microkeratome LASIK surgery (M-LASIK group) were included from our department from July 2011 to July 2012. Uncorrcted visual acuity, dry-eye syndromes including tear film break-up time (BUT), Schirmer Ⅰ test, and corneal fluorescein staining, corneal topography data, and subjective symptoms evaluated with questionnaire were recorded and compared between these two groups.

  Results  Primary healing was achieved in both groups. In F-LASIK group, 1 eye had a little fold of flap on the fist postoperative day, which was improved after washing. The expected uncorrected visual acuity was achieved within 1 month after surgery in both groups. The values of steep keratometric power (K₁) and flat keratometric power (K₂) were significantly decreased 1 month after operation in both groups (P < 0.05), whereas no significant difference was found between these two groups (P>0.05). BUT and Schirmer Ⅰ test results were significantly declined 1 month after surgery, and the FS score significantly increased (P < 0.05). One month after the operation, the average BUT was significantly longer in F-LASIK group than in M-LASIK group (P=0.045). Schirmer Ⅰ test results and the FS score were not significantly different between these two groups (P>0.05). The total score of 9 symptoms in F-LASIK group was significantly lower than that in M-LASIK group (Z=-0.989, P=0.043). The score of satisfaction in F-LASIK group was significantly higher than that in M-LASIK group (Z=-2.316, P=0.021).

  Conclusions  Both traditional LASIK and FEMTO LDV LASIK can achieve good visual acuity and improve quality of life. However, the incidence and severity of dry eye is lower in FEMTO LDV LASIK than in traditional LASIK.