The impact of flap creation methods for Sub-Bowman's Keratomileusis (SBK) on the central thickness of Bowman's layer

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? 2015 Xu et al.Purpose: To determine the impact of flap creation methods for sub-Bowman's keratomileusis (SBK) on central Bowman 's layer thickness. Methods: SBK flaps were made by Moria microkeratome for 20 subjects and by femtosecond (FEMTO) laser for 21 subjects. Corneal sublayer thicknesses were measured by ultra-high resolution optical coherence tomography before SBK and at 1 day, 1 week, 2 weeks, and 1 month afterwards. Each subject was imaged twice on each visit. Thicknesses of central epithelium, Bowman's layer, flap, and total cornea were calculated using a custom-made automated image processing algorithm. The repeatability of sublayer thickness measurements was tested by the intraclass correlation coefficient (ICC) and by the coefficient of repeatability (CoR) at 1 week post-SBK. Results: ICCs of the Moria and FEMTO groups were ?0.959 and ?0.961 respectively for all sublayer measurements. The segmentation CoRs were less than 6.78% and 5.63%respectively. For both groups, microdistortions were present in the epithelium and Bowman's layer after SKB. The flap thickness of the Moria group was 9.8 ? m (95% confidence interval: 4.8-14.8?m) thinner than the FEMTO group one day after SBK (independent samples t-test, P < 0.05). Bowman's layer became thicker by 1.6 ? 1.1 ?m and 1.7 ? 1.6 ?m one day post-SBK for the Moria and FEMTO groups (repeated ANOVA, P < 0.05) and then remained stable. Corneal and sublayer thickness were similar between the two groups. Conclusions: Central Bowman's layer thickness increased 1 day post-SBK. Flap creation by Moria microkeratome and femtosecond laser did not have significantly different impacts on Bowman's layer thickness following SBK. Trial Registration: Chinese Clinical Trial Registry (ChiCTR) NO: ChiCTR-OCH-14004525.




Xu, Z., Shen, M., Hu, L., Zhuang, X., Peng, M., Hu, D., … Lu, F. (2015). The impact of flap creation methods for Sub-Bowman’s Keratomileusis (SBK) on the central thickness of Bowman’s layer. PLoS ONE, 10(5).

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