LASIK Using the Manual Microkeratome: Complications, Management, and Result.
- Author:
Seung Wook CHANG
1
;
Choun Ki JOO
Author Information
1. Department of Ophthalmology, Kangnam St. Marys Hospital, The Catholic University of Korea, College of Medicine.
- Publication Type:Original Article
- Keywords:
Learning curve;
Manual microkeratome;
LASIK
- MeSH:
Bowman Membrane;
Corneal Stroma;
Epithelium, Corneal;
Keratomileusis, Laser In Situ*;
Lasers, Excimer;
Learning Curve;
Methods;
Photorefractive Keratectomy
- From:Journal of the Korean Ophthalmological Society
1998;39(7):1392-1400
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Laser in situ kratomileusis(LASIK) is a prefered method to excimer laser photorefractive keratectomy (PRK) because the former cuts only corneal stroma, while the latter cuts corneal epithelium, Bowmans membrane, and stroma, LASIK is a complex procedure composed of corneal flap preparation and photo-ablation. In corneal flap preparation, two types, manual and automatic, of microkeratomes have been used. We experienced problems during and after LASIK procedure using a manual microkeratome in learning curve period(8 months) and criticized the problems to shorten a learning curve of manual microkeratome. One hundred eighty six myopic eyes treated with LASIK using manual microkeratome(MLK, SCMD, USA) from January 1997 to August 1997 by one operator(Joo) were subjects. Problems occurred in 24 eyes(12.9%) and consisted of hole in corneal flap (5 eyes), thin corneal flap(3 eyes), winkling of corneal flap (2 eyes), hinge inside optical zone of laser(3 eyes), haze of interface (3 eyes), and free corneal flap(8 eyes). Majority of complications occurred in the first 3 months and most complicated cases were preventable when the speed of microkeratome enhancement was slow in late series of study. It seems that a manual microkeratome takes longer learning curve than automated microkeratome. Therefore, to decrease the number of problem cases in learning curve of LASIK using manual microkeratome a didatic course, advices from experienced surgeons, and participation in wet lab would be mandatory.
