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Title: Femtosecond lenticule extraction (FLEx): Clinical results, interface evaluation, and intraocular pressure variation
Authors: Ang, M.
Chaurasia, S.S.
Angunawela, R.I.
Poh, R.
Riau, A.
Tan, D.
Mehta, J.S. 
Issue Date: Mar-2012
Citation: Ang, M., Chaurasia, S.S., Angunawela, R.I., Poh, R., Riau, A., Tan, D., Mehta, J.S. (2012-03). Femtosecond lenticule extraction (FLEx): Clinical results, interface evaluation, and intraocular pressure variation. Investigative Ophthalmology and Visual Science 53 (3) : 1414-1421. ScholarBank@NUS Repository.
Abstract: PURPOSE. To characterize the clinical profile of femtosecond lenticule extraction (FLEx) correlated with ultrastructural analysis of the corneal interface and in vivo real-time intraocular pressure (IOP). METHODS. Prospective clinical case series with experimental studies; consecutive patients underwent FLEx at a single tertiary center over 10 months with postsurgical follow-up of 3 months. The patients were divided into three groups according to spherical equivalence (SE) (A, < -5.0 diopters [D]; B, ≥ -5.00 D and < -9.00 D; and C, ≥ -9.0 D). Twelve human cadaveric eyes analyzed using scanning electron microscopy after receiving FLEx; 40 rabbit eyes received FLEx with in vivo IOP measurements. The main outcome measures were refractive outcomes from study subjects; with corneal interface and IOP in experimental studies. RESULTS. Thirty-three subjects (22 females, 66.7%) underwent FLEx in both eyes (66 eyes). Mean age was 32 years (range, 21 to 46 years). Preoperative mean SE was -5.77 ± 2.04 D with astigmatism of -1.03 ± 0.72 D. There was a slight hyperopic shift (mean SE 0.14 ± 0.53 D); 94% achieved uncorrected visual acuity ≥20/25 3 months postoperatively. Refractive stability was achieved within 1 month (P < 0.001). Ultrastructurally, the smoothness of the corneal interface was independent of ablation depth (mean irregularity scores A, B, C: 8.8 ± 0.6, 10.3 ± 0.4, 8.7 ± 0.6, respectively; P = 0.88). The increase in IOP during FLEx was similar to that in femtosecond (FS)-LASIK, albeit a twofold duration of raised IOP in FLEx (P < 0.001). CONCLUSIONS. These results suggest that FLEx is predictable and effective in treating myopia and myopic astigmatism. Experimental studies support the early clinical results and safety of this procedure. © 2012 The Association for Research in Vision and Ophthalmology, Inc.
Source Title: Investigative Ophthalmology and Visual Science
ISSN: 01460404
DOI: 10.1167/iovs.11-8808
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