Surface quality of human corneal lenticules after femtosecond laser surgery for myopia comparing different laser parameters

Abstract

To determine the surface characteristics of human corneal lenticules after femtosecond laser surgery for myopia. The Carl Zeiss Meditec AG VisuMax® femtosecond laser system was used for refractive correction called Femtosecond Lenticule Extraction on 24 myopic eyes. The surface regularity on the refractive corneal lenticules recovered was evaluated by assessing scanning electron microscopy images using an established scoring system. Three different energy levels 150, 180, and 195 nJ were compared (n = 8 in each group). Surface irregularities were caused by tissue bridges, cavitation bubbles, or scratches. The surface regularity index (R² = 0.74) decreased as pulse energy increased. The average surface regularity score obtained was 7.5 for 150 nJ, 7.25 for 180 nJ, and 6.25 for 195 nJ. The human corneal lenticules created with the VisuMax® femtosecond laser system are of predictable, good-quality surface. This study shows the influence of pulse energy on surface regularity in human eyes. Further studies should focus on optimization of laser parameters as well as surgical technique to improve the regularity of the corneal stromal bed and so make the advantages of the femtosecond laser technology over conventional techniques clearer in the future.