EyeWorld
March, 2006
Point: Should We Abandon Mechanical Microkeratomes?
Quote:
Any surgical procedure has potential complications. The creation of a lamellar flap is a surgical procedure and has certain risks whether the flap is made with a laser or a blade.
No instrument, whether a laser or a mechanical microkeratome, is complication free. I think the complications between two different devices may also be different, but to infer that a laser device is complication free is implausible. Complications such as ectasia, buttonholes, and DLK are risks with both femtosecond and mechanical microkeratomes. Others such as transient light sensitivity (TLS), are specific to the femtosecond microkeratome.
One area of recent debate is the development of thin flap LASIK. Some report that by using the femtosecond laser (IntraLase, Irvine, Calif.) surgeons can create a thinner flap than a mechanical microkeratome and avoid some of the potential complications associated with creating thicker flaps with a mechanical microkeratome.
However, I would argue that whether a flap is thick or thin, the creation of a flap is still surgical incision and, therefore, still has the potential for complications such as dry eye and ectasia. If there is any concern about creating a flap, I believe surface ablation should be performed. I think thin-flap LASIK should be ?no-flap? LASIK.
Read the entire article at
http://www.eyeworld.org/article.php?sid=3055