Comparison of the Femtosecond Laser and Mechanical Keratome for Laser In Situ Keratomileusis

Abstract

Objective To compare clinical outcomes between fellow eyes randomized to femtosecond laser–created flaps (femtosecond group) or mechanical keratome–created flaps (mechanical group) during wavefront-guided laser in situ keratomileusis. Design Prospective, randomized, comparative clinical study. Main Outcome Measures Efficacy, safety, predictability, stability, changes in corneal optical aberrations, and low-contrast visual acuity before and 1 week and 1, 3, 6, and 12 months after surgery. Results Forty-three patients underwent evaluation in this study. One month after surgery, the mean (SD) spherical equivalent was −0.15 (0.30) diopters (D) for the femtosecond group and −0.12 (0.29) D for the mechanical group (differences were not statistically significant). Twelve months after surgery, 39 eyes (98%) in the femtosecond group had uncorrected visual acuity of 20/20 or better compared with 37 (95%) in the mechanical group. The femtosecond group had fewer high-order, spherical, and coma aberrations and more trefoil aberrations than the mechanical group at 1 month (P = .55), 3 months (P = .05), 6 months (P = .33), and 12 months (P = .48) after surgery. At 25% contrast, the femtosecond group had gains at 1 month (P = .01) and 6 months (P = .008) after surgery. Conclusion Twelve months after keratomileusis, clinical outcomes were similar for both groups.