Risk factors for early flap misalignment following microkeratome-assisted laser in situ keratomileusis: A retrospective large database analysis

被引:2
作者
Friehmann, Asaf [1 ]
Mimouni, Michael [2 ,3 ]
Assad, Negme [3 ]
Rabina, Gilad [4 ]
Spierer, Oriel [5 ]
Nemet, Achia [5 ]
Kaiserman, Igor [6 ,7 ,8 ]
机构
[1] Tel Aviv Univ, Sackler Fac Med, Meir Med Ctr, Dept Ophthalmol, Tel Aviv, Israel
[2] Rambam Hlth Care Campus, Dept Ophthalmol, Haifa, Israel
[3] Technion Israel Inst Technol, Ruth & Bruce Rappaport Fac Med, Haifa, Israel
[4] Tel Aviv Univ, Sackler Sch Med, Sourasky Med Ctr, Div Ophthalmol, Tel Aviv, Israel
[5] Tel Aviv Univ, Sackler Fac Med, Wolfson Med Ctr, Dept Ophthalmol, Tel Aviv, Israel
[6] Care Vis Laser Ctr, Tel Aviv, Israel
[7] Ben Gurion Univ Negev, Barzilai Med Ctr, Dept Ophthalmol, Beer Sheva, Israel
[8] Ben Gurion Univ Negev, Fac Hlth Sci, Beer Sheva, Israel
关键词
Flap misalignment; flap risk factors; laser in situ keratomileusis; macrostriae; microstriae; DIFFUSE LAMELLAR KERATITIS; EPITHELIAL INGROWTH; CORNEAL FLAP; COMPLICATIONS; LASIK; OUTCOMES; STRIAE; TEMPERATURE; PREVENTION; DIAGNOSIS;
D O I
10.1177/1120672119892431
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Purpose: To determine factors associated with early flap misalignment following microkeratome-assisted laser in situ keratomileusis. Materials and Methods: This retrospective study included the right eyes of consecutive patients who underwent laser in situ keratomileusis procedure between 2005 and 2016 at Care-Vision Laser Centers, Tel-Aviv, Israel. Patients were divided into two groups according to whether or not they subsequently developed early flap misalignment. Results: A total of 14,582 eyes (mean age of patients: 32.4 +/- 10.3 years) were included. Post-laser in situ keratomileusis early flap misalignment developed in 158 eyes (1.1%). Misalignment was more frequent during the spring (32.3% vs 22.8%, p = 0.003) and in a higher operating room temperature (23.34 +/- 1.06 vs 22.98 +/- 1.26, p < 0.001). In addition, in the misalignment group, there was a higher rate with the of use of the a Moria M2 microkeratome (rather than sub-Bowman's keratomileusis microkeratome) head (55.2% vs 40.5%, respectively, p < 0.001). In a multivariable analysis adjusted for surgeon and year of surgery, high operating room temperature (odds ratio = 1.22, p = 0.006), treatment zone of 9.0 mm (as opposed to smaller treatment zones, odds ratio = 1.54, p = 0.04), and springtime (odds ratio = 1.58, p = 0.02) were associated with flap misalignment. There was a significant difference in misalignment rates between surgeons (p = 0.02). Conclusion: This study found that larger treatment zones, higher operating room temperature, operating during the spring, and the use of Moria M2 microkeratome were associated with increased flap misalignment rates. The association with operating room temperature and seasonal variation is of interest and merits further research.
引用
收藏
页码:385 / 389
页数:5
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