Reported Advantages of SBK Compared to conventional LASIK
Less weakening of corneal biomechanics, less risk of ectasia, better stability.
Faster visual recovery.
Better quality of vision: fewer higher order aberrations, better contrast sensitivity.
Fewer complications, less glare, fewer halos.
Less incidence of postoperative dry eye.
Reduced loss of corneal sensitivity.
Greater flap thickness predicatibility.
Ability to treat more patients, and higher levels of myopia.
Can treat thinner corneas.
Reduced enhancement rate.
Planar, Predictable Flaps and Stromal Beds of Unrivaled Smoothness
Thin flaps with planar architecture.
Unrivalled bed smoothness.
Accuracy and predictability equivalent to Femto SBK.
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Outcomes of wavefront-optimized Sub-Bowman Keratomileusis (SBK) Malhotra et al. (Chandigarh, India)
In their article 1, Malhotra et al. (Chandigarh, India) performed a prospective comparative clinical study in order to compare the outcomes of wavefront-optimized Sub-Bowman Keratomileusis (SBK) performed using:
· One Use-Plus SBK (OUP)(Moria SA, Antony, France) automated microkeratome in 25 myopic patients with astigmatism up to a maximum of 2 D;
· and the latest generation 150 kHz IntraLase® (iFS) femtosecond laser (Abbott Medical Optics, Santa Ana, CA, USA) in another group of 25 myopic patients with astigmatism up to a maximum of 2 D;
All treatment parameters were the same, and all suitable patients were followed up at 1 day, 1 week, 1 month and 3 months after surgery. Postoperative refraction and wavefront measurements were conducted by optometrists who were blinded to the method of flap creation.
Authors found that:
· efficacy, refractive stability, predictability, and safety profiles were comparable between the two groups;
· visual acuity outcomes were similar irrespective of whether flaps were made by a femtosecond laser or by the Moria automated microkeratome;
· although higher order aberrations (HOAs) increased significantly in both groups after SBK, the iFS group was associated with a significantly higher induction of both total HOAs and spherical aberrations compared to the OUP group;
Based on their prospective clinical study, Malhotra et al. therefore concluded:
flaps created using the Moria One Use-Plus SBK microkeratome were associated with significantly lower induction of total HOAs and spherical aberrations as compared with 150 kHz iFS flaps at the end of 3 months follow-up.
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Keep your LASIK in mechanical microkeratome
James Lewis, MD (Elkins Parks, PA - USA)
"Click-Free LASIK": have you already heard of a SBK procedure without any click-fees? compared to elevated cost associated of the routinely use of a femtosecond laser. In addition of that cost point of view, Dr. Lewis highlighted the efficacy of the Moria One Use-Plus SBK microkeratome to create 100-micron flaps with a high degree of accuracy, predictability and reproducibility. AS-OCT pictures show the perfect architecture of mechanically created sub-Bowman's flaps. Get the whole story here...