Clinical Ophthalmology (Aug 2017)
Accuracy of Alcon WaveLight® EX500 optical pachymetry during LASIK
Abstract
Mark D Mifflin,1 Xavier M Mortensen,1 Brent S Betts,1 Cole Gross,2 Brian Zaugg1 1Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah, Salt Lake City, UT, 2University of Nevada School of Medicine, Reno, NV, USA Purpose: To study the accuracy and reliability of optical pachymetry using the Alcon WaveLight EX500 during laser-assisted in situ keratomileusis (LASIK). Materials and methods: This was a retrospective chart review of 90 eyes from 45 patients who had undergone LASIK (mean age 35.2±8.2 years; 19 males, 26 females). The WaveLight FS200 femtosecond laser was programmed to cut LASIK flaps at a desired depth of 120 µm. Optical low-coherence reflectometry (WaveLight EX500) was used to measure central corneal thickness prior to lifting the flap, and the residual stromal bed immediately after excimer ablation. Flap thickness (FT) was calculated using simple subtraction. Optical coherence tomography (OCT) was used to measure central corneal thickness, flap thickness, and residual stromal bed in the postoperative period and the results compared to intraoperative measurements. Results: Mean programmed FS200 FT was 119 µm. Mean FT using EX500 optical pachymetry was 109 µm. The difference between FS200- programmed and EX500-measured FT was 9 µm (P<0.001). There was also a significant difference between the EX500 and OCT FT (109 µm vs 119 µm, respectively; P<0.001). Conclusion: FT values calculated using intraoperative EX500 optical pachymetry were significantly lower than programmed FS200 values or OCT measurements. Keywords: flap thickness, optical coherence tomography, femtosecond laser