Corneal Ablation Depth Readout of the MEL 80 Excimer Laser Compared to Artemis Three-dimensional Very High-frequency Digital Ultrasound Stromal Measurements

PURPOSE: To evaluate the accuracy of the ablation depth readout for the MEL 80 excimer laser (Carl Zeiss Meditec). METHODS: Artemis 1 very high-frequency digital ultrasound measurements were obtained before and at least 3 months after LASIK in 121 eyes (65 patients). The Artemis-measured ablation depth was calculated as the maximum difference in stromal thickness before and after treatment. Laser in situ keratomileusis was performed using the MEL 80 excimer laser and the Hansatome microkeratome (Bausch & Lomb). The Aberration Smart Ablation profile was used in 56 eyes and the Tissue Saving Ablation profile was used in 65 eyes. All ablations were centered on the corneal vertex. Comparative statistics and linear regression analysis were performed between the laser readout ablation depth and Artemis-measured ablation depth. RESULTS: The mean maximum myopic meridian was -6.66 +/- 2.40 diopters (D) (range: -1.50 to -10.00 D) for Aberration Smart Ablation-treated eyes and -6.50 +/- 2.56 D (range: -1.34 to -11.50 D) for Tissue Saving Ablation-treated eyes. The MEL 80 readout was found to overestimate the Artemis-measured ablation depth by 20 +/- 12 mu m for Aberration Smart Ablation and by 21 +/- 12 mu m for Tissue Saving Ablation profiles. CONCLUSIONS: The accuracy of ablation depth measurement was improved by using the Artemis stromal thickness profile measurements before and after surgery to exclude epithelial changes. The MEL 80 readout was found to overestimate the achieved ablation depth. The linear regression equations could be used by MEL 80 users to adjust the ablation depth for predicted residual stromal thickness calculations without increasing the risk of ectasia due to excessive keratectomy depth as long as a suitable flap thickness bias is included. [J Refract Surg. 2010; 26(12):949-959.] doi:10.3928/1081597X-20100114-02