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Optical Online Pachymetry in Laser In Situ Keratomileusis
Wirbelauer C., Häberle H., Pham D.-T.,
Vivantes Klinikum Neukölln, Klinik für Augenheilkunde (Berlin)
Purpose: Currently the microkeratome cut and the ablation depth are unpredictable in laser in situ keratomileusis (LASIK). Optical online pachymetry is a high-resolution and noncontact method, which enables to monitor these values intraoperatively.
Method: In 7 patients undergoing LASIK (Supratome und Esiris, Schwind) optical online pachymetry (4Optics AG) with a wavelength of 1310 nm and a measurement frequency of 74 Hz was studied. The central flap- and residual stromal thickness as well as the ablation depth were determined.
Results: Optical online pachymetry enabled to visualize and assess intraoperatively the corneal thickness, the flap thickness after the microkeratome pass, the time-resolved ablation and the residual stromal thickness. Intraoperatively the flap thickness was 141±30 µm and the residual stromal thickness 274±24 µm. The optically determined ablation depth was 116±10 µm, which corresponded to 24% higher values than the nominal ablation depth.
Conclusions: Optical online pachymetry enabled to measure the flap and residual stromal thickness intraoperatively. Also the individual ablation depth and possible dehydration of the cornea was monitored continuously. Thus, optical online pachymetry can contribute to secure intraoperatively the corneal biomechanics in LASIK.