Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Mar 7:10:393-404.
doi: 10.2147/OPTH.S99394. eCollection 2016.

Femtosecond lasers for laser in situ keratomileusis: a systematic review and meta-analysis

Anne Huhtala  1 , Juhani Pietilä  2 , Petri Mäkinen  2 , Hannu Uusitalo  3
Affiliations

Femtosecond lasers for laser in situ keratomileusis: a systematic review and meta-analysis

Anne Huhtala et al. Clin Ophthalmol. .

Abstract

Purpose: The aim of this study was to review and meta-analyze whether there are differences between reported femtosecond (FS) lasers for laser-assisted in situ keratomileusis (LASIK) in terms of efficacy, predictability, and safety as primary outcomes and corneal flap thickness measurements and pre- and postoperative complications as secondary outcomes.

Methods: A comprehensive literature search of PubMed, Science Direct, Scopus, and Cochrane CENTRAL Trials Library databases was conducted to identify the relevant prospective randomized controlled trials of FS lasers for LASIK. Thirty-one articles describing a total of 5,404 eyes were included.

Results: Based on efficacy, IntraLase FS 10 and 30 kHz gave the best results. Based on predictability and safety, there were no differences between various FS lasers. FEMTO LDV and IntraLase FS 60 kHz produced the most accurate flap thicknesses. IntraLase and Wavelight SF200 had the fewest intraoperative complications. IntraLase, Visumax, and Wavelight FS200 had the most seldom postoperative complications.

Conclusion: There were dissimilarities between different FS lasers based on efficacy and intraoperative and postoperative complications. All FS lasers were predictable and safe for making corneal flaps in LASIK.

Keywords: LASIK; femtosecond laser; laser in situ keratomileusis; meta-analysis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart of study selection.
Figure 2
Figure 2
Efficacy, the proportion of eyes within UDVA ≥20/20 after FS laser for LASIK. Abbreviations: χ2, chi-square statistic; CI, confidence interval; df, degrees of freedom; FS, femtosecond; LASIK, laser-assisted in situ keratomileusis; UDVA, uncorrected distance visual acuity.
Figure 3
Figure 3
Predictability, the proportion of eyes within ±0.5 D of target refraction after FS laser for LASIK. Abbreviations: χ2, chi-square statistic; CI, confidence interval; D, diopters; df, degrees of freedom; FS, femtosecond; LASIK, laser-assisted in situ keratomileusis; ns, nonsignificant.
Figure 4
Figure 4
Safety, the proportion of eyes losing two or more Snellen lines of CDVA after FS laser for LASIK. Abbreviations: CDVA, corrected distance visual acuity; χ2, chi-square statistic; CI, confidence interval; df, degrees of freedom; FS, femtosecond; LASIK, laser-assisted in situ keratomileusis; ns, nonsignificant.
Figure 5
Figure 5
Corneal flap measurements after FS laser for LASIK. Abbreviations: F, F factor; FS, femtosecond; LASIK, laser-assisted in situ keratomileusis; ns, nonsignificant; SD, standard deviation.
Figure 6
Figure 6
Intraoperative complications after FS laser for LASIK. Abbreviations: χ2, chi-square statistic; CI, confidence interval; df, degrees of freedom; FS, femtosecond; IO, intraoperative; LASIK, laser-assisted in situ keratomileusis.
Figure 7
Figure 7
Postoperative complications after FS laser for LASIK. Abbreviations: χ2, chi-square statistic; CI, confidence interval; df, degrees of freedom; FS, femtosecond; LASIK, laser-assisted in situ keratomileusis; PO, postoperative.
See this image and copyright information in PMC

References

    1. Sugar A, Rapuano CJ, Culbertson WW, et al. Laser in situ keratomileusis for myopia and astigmatism: safety and efficacy – a report by the American academy of ophthalmology. Ophthalmology. 2002;109(1):175–187. - PubMed
    1. Varley GA, Huang D, Rapuano CJ, Schallhorn S, Wachler BSB, Sugar A. LASIK for hyperopia, hyperopic astigmatism, and mixed astigmatism – a report by the American Academy of Ophthalmology. Ophthalmology. 2004;111(8):1604–1617. - PubMed
    1. Stonecipher K, Ignacio TS, Stonecipher M. Advances in refractive surgery: microkeratome and femtosecond laser flap creation in relation to safety, efficacy, predictability, and biomechanical stability. Curr Opin Ophthalmol. 2006;17(4):368–372. - PubMed
    1. Pietilä J. Flap Creation in Laser-Assisted in Situ Keratomileusis: From Microkeratome to Femtosecond Laser. Tampere: Tampere University Press; 2012.
    1. Kurtz RM, Liu X, Elner VM, Squier JA, Du D, Mourou GA. Photodisruption in the human cornea as a function of laser pulse width. J Refract Surg. 1997;13(7):653–658. - PubMed

LinkOut - more resources