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Thin flap LASIK has advantages over thicker flaps
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BOSTON — LASIK with a 100 µm flap induces less corneal weakness than LASIK with thicker flaps, allowing higher power corrections, according to a surgeon speaking here.
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Michael C. Knorz, MD, discussed considerations in flap thickness selection in lamellar surgery at the American Society of Cataract and Refractive Surgery Summer Refractive Congress. He said early LASIK procedures often involved thin corneal flaps, but complications led to the use of thicker flaps, in the range of 130 µm to 180 µm. However, the introduction of femtosecond lasers, such as the IntraLase FS laser, is bringing renewed interest to performing LASIK using thinner flaps, he said.
“It’s a pretty much straightforward procedure,” he said. “We weaken the cornea less, which is definitely an advantage.”
Dr. Knorz cited a retrospective study of 280 eyes by R. Cobo-Soriano and colleagues, published in the Journal of Cataract and Refractive Surgery. Those authors found that patients with thin flaps achieved better uncorrected visual acuity compared with patients with thicker flaps. They also had lower re-treatment rates and better contrast sensitivity.
However, thinner flaps have some drawbacks, Dr. Knorz said. Flaps around 100 µm thick have less of an adverse biomechanical effect, but they are not as stable as thicker flaps. Thinner flaps can also increase the risk of flap-related complications, and excessively thin flaps, ranging from 70 µm to 80 µm, do not appear to be as effective, Dr. Knorz said.
“We should probably stay around 100 µm,” he said.