Eficacitatea metodei Laser in situ Keratomileusis cu formarea lamboului ultrafin la pacienţii cu grosimea corneei sub 500 microni

Abstract

Background: Until recently, the ideal thickness of the corneal flap was considered as 130 μm or more. Many surgeons are reviewing options for a perfect corneal flap due to the specific histology of corneal stroma in the upper part, the ability to save the biomechanical integrity of the cornea. The aim was to evaluate the refractive results of laser in situ keratomileusis (LASIK) with formation of ultrathin corneal flap in myopiс patients with thin corneas. Material and methods: The study included 39 patients (75 eyes) aged 25 to 38 years (mean 31 ± 5.4 years) with myopia of low, medium and high grade, who had a preoperative central corneal thickness (CCT) of less than 500 microns and completed at least 2 years of follow-up examinations after surgery. All eyes were randomly divided into 3 groups of 25 each depending on the degree of myopia. Results: Mean preoperative corneal pachymetry was 488.6 ± 11.2 μm in group A, 486.9 ± 10.4 μm in group B and 489.1 ± 10.8 μm in group C. No intraoperative complications were found in all groups. None of the included eyes developed postrefractive corneal ectasia. The predictability index at 24 months after surgery for group A was 1.09, for group B was 1.07 and for group C was 1.16. The mean calculated residual stromal bed was 358.8 ± 45.6 μm in group A, 324.9 ± 42.5 μm in group B and 299.7 ± 37.9 μm in group C. Conclusions: Refractive laser surgery with LASIK in patients with thin corneas (less than 500 microns) seems to be a safe and predictable technique for myopic refractive corrections. No intraoperative or early or late postoperative complications were observed. Patients noted a rapid recovery of visual functions. The achieved refractive outcomes were stable.