Journal of the Korean Ophthalmological Society 2004;45(2):187-194.
Published online February 1, 2004.
Simultaneous LASIK on both Stromal Surface and Flap Undersurface for High Myopia with Insufficient Corneal Bed.
Hyo Chang Hong, Jae Ho Kim
1Department of Ophthalmology, Inje University Sanggye Paik Hospital, Korea. kimjheye@ijnc.inje.ac.kr
2Department of Ophthalmology, Inje University Seoul Paik Hospital, Korea.
고도근시와 얇은 각막에 대해 각막편의 내면 실질부에 라식수술의 동시추가변법의 효과
홍효창 ( Hong Hyo Chang ) , 김재호 ( Kim Jae Ho )
Abstract
PURPOSE
To develop a newly modified technique, which is simultaneous laser in situ keratomileusis on both corneal flap undersurface (LASIK-Flap) and the corneal stromal surface, in eyes with insufficient corneal bed of high myopia and thin cornea. METHODS: We performed simultaneous laser in situ keratomileusis on both corneal flap undersurface (LASIK-Flap) and the corneal stromal surface in 38 eyes of 22 patients with high myopia (ranged from SE -4.00D to -14.25D)and corneal thickness (ranged from 435 to 570 micro meter) . In these eyes, all procedures of 130 ~ 160 micro meter thickness of the flap preparation with hinge were successfully made with a use of the Moria M2 microkeratome. The ablation on both the corneal surface and the flap undersurface using VISX star S4 with active track was performed with a plan of postoperative residual corneal stromal bed >250micro meter. We evaluated the changes of visual acuity, refractive error, pachymetry, corneal topography and mesotest for at least 6 months after surgery. Preservation of normal wet state on the flap in very important in procedures. RESULTS: Mean SE was -9.32 +/- 2.75D and mean corneal thickness was 513.37 +/- 36.96 micro meter ranged from 435 micro meter to 570 micro meter before LASIK. Ablation depth of flap undersurface was 48.87 +/- 26.67 micro meter ranged from 6 micro meter to 100 micro meter, and post LASIK spherical equivalent was +0.02 +/- 0.62D (ranged +2.50 ~ -1.50D). No vision concerned complication was found. Follow-up was ranged from 1week to 6 months. CONCLUSIONS: LASIK-flap procedure has an advantage in eyes with insufficient corneal thickness in high myopia.
Key Words: Flap undersurface ablation;LASIK-flap;LASIK;Thin cornea
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