December 15, 2006
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SBK will be next trend in laser refractive surgery

Sub-Bowman's keratomileusis could advance laser surgery beyond LASIK and PRK

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LAS VEGAS — Sub-Bowman’s keratomileusis will become the next trend in laser refractive surgery, combining advantages of both PRK and LASIK, a surgeon speaking here predicted.

Daniel S. Durrie. MD
Daniel S. Durrie

In sub-Bowman’s keratomileusis, or SBK, a femtosecond laser is used to create a corneal flap just below the level of Bowman’s membrane, at a depth of 60 µm to 70 µm, according to Daniel S. Durrie, MD.

This is “the optimal flap,” according to Dr. Durrie, OSN Refractive Surgery Section Editor.

At the American Academy of Ophthalmology meeting, Dr. Durrie discussed results from a prospective, randomized, contralateral eye study comparing SBK and surface ablation in 100 eyes of 50 patients.

The IntraLase FS (IntraLase Corp.) was used to create the 60-µm to 70-µm flap, and the ablations were performed using Alcon’s LADARVision CustomCornea excimer laser system.

Dr. Durrie used the Visante OCT (Carl Zeiss Meditec) to measure flap thickness at several locations and found a standard deviation of less than 5 µm at any point.

“[The cornea] is flat as pancakes,” he said. “This is important because if you go thin, you must have consistency.”

Eyes treated with the SBK procedure showed decreased postoperative dry eye, lower reported corneal sensitivity, similar amounts of higher-order aberrations and a higher rate of overall patient satisfaction, Dr. Durrie said.

“We are now moving beyond PRK and LASIK,” Dr. Durrie said. “We will be hearing a lot about SBK.”