Moria One-Use Plus sub-Bowman’s keratomileusis head: a useful tool in the refractive surgeon’s armamentarium

Abstract

Patients and methods A total of 500 eyes of 250 patients underwent laser in situ keratomileusis (LASIK) surgery using the One-Use Plus sub-Bowman’s keratomileusis head for the creation of an ultrathin LASIK flap. During the follow-up at 1, 6, 12, and 24 months, both uncorrected visual acuity (UCVA) and best-corrected visual acuity were recorded. A keratoconus screening corneal topography was carried out during the last follow-up visit. Results A total of 500 eyes of 250 myopic patients were included in this study. There were 115 male patients and 135 female patients. The mean age was 27.5 years (range: 18–44 years). The mean preoperative refractive error was −5.0 diopter sphere (DS) (range: −3 to −9 DS). The mean cylindrical error was −2.5 diopter cylinder (DC) (range: −0.75 to −4.5 DC). The mean UCVA was 0.07 (range: 0.01–0.3), and it improved to 1.0 (range: 0.8–1.25) on day 1 postoperatively. At the end of the follow-up, the mean UCVA was 1.0 and the mean best-corrected visual acuity was 1.0. The mean stromal residual bed thickness was 362 μm (range: 304–466 μm), and the mean central flap thickness was 102 μm (range: 82–120 μm). Complications were perilimbal bleeding in 15 eyes and fine irregular stromal edge cuts at the sides of the hinge in 10 eyes. There were no epithelial defects, no epithelial heaping or sliding, no irregular stromal bed surface cuts, no free caps or button holes, or incomplete flaps. Diffuse lamellar keratitis occurred in one eye of one patient, and no slipped flaps, macrostriae or microstriae, or epithelial downgrowth was seen during the follow-up period. At the end of the follow-up period none of our patients had topographic evidence of keratoconus. Conclusion The One-Use Plus sub-Bowman’s keratomileusis head is a safe and effective method for creating an ultrathin LASIK flap and allows the surgeon to treat higher errors of refraction while maintaining a higher safety margin by leaving more residual stromal tissue.