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Pachymetry measurements integral to decreased complications
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THOROFARE, N.J. — The best way to avoid flap complications such as button-holes or irregular keratectomies is to create a nomogram for each microkeratome used, according to Stephen Updegraff, MD.
Dr. Updegraff performed a study comparing Moria's CB and M2 microkeratomes and discovered the importance of intraoperative pachymetry to generate nomograms for all microkeratomes.
"Our pachymetry measurements were taken before making the flap, and when the flap was made I would measure the bed and determine the flap thickness by subtraction," Dr. Updegraff said.
He found that "all microkeratomes were very dependent, with P-values less than .001, on the actual central corneal thickness." So if the cornea was thin, the microkeratome would produce a thin flap; if the cornea was thick, the microkeratome would produce a thick flap.
Dr. Updegraff added that the study is "significant" because most surgeons "won't do intraoperative pachymetry because they think it's not accurate." But his study showed a significant correlation of results with intraoperative measurements, he said.
More details of Dr. Updegraff's study will appear in the Nov. 1, 2001, issue of Ocular Surgery News.