The Accuracy of Flap Thickness and Diameter in LASIK Using a Femtosecond Laser

Wexler S, Hall B. The accuracy of flap thickness and diameter in LASIK using a femtosecond laser. Clinical Ophthalmology 2023;17:3877-3882.


To evaluate the resultant thickness of the WaveLight FS200 (Alcon Vision, LLC) created LASIK flap compared to intended thickness at the surgical visit, using the WaveLight EX500 (Alcon Vision, LLC) pachymeter and the resultant flap diameter compared to intended diameter.


This single arm, prospective, single surgeon study assessed the accuracy of the intended flap thickness and diameter, after successful bilateral LASIK surgery. The WaveLight FS200 femtosecond laser was used to create all flaps with an intended thickness of 120 μm. Flap thickness was calculated by subtracting the stromal bed thickness after flap lift from the preoperative corneal thickness using the WaveLight EX500 on-board optical pachymeter. Flap diameter was determined using digital analysis.


A total of 58 subjects (116 eyes) completed the study. The calculated mean flap thickness was 120.6 ± 9.0 μm (range 102 to 143 μm) using the EX500 pre- and post-flap pachymetry measurements. There was no statistically significant difference between the planned and achieved flap thickness (p > 0.05). The mean difference in flap diameter between planned and actual was 0.02 ± 0.05 mm. Corneal thickness measured by Pentacam at up to 2 months preoperatively versus EX500 just prior to surgery was similar, with EX500 measuring 2 μm less on average than the Pentacam.


The results suggest that the WaveLight FS200 laser is reliable for LASIK flap thickness and diameter and accurately created flaps at the intended thickness and the intended diameter.

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