Prediction model of free flaps in microkeratome-assisted LASIK

TY - JOUR

T1 - Prediction model of free flaps in microkeratome-assisted LASIK

AU - Katz, Toam

AU - Druckiv, Vasyl

AU - Siebelmann, Sebastian

AU - Frings, Andreas

AU - Skevas, Christos

PY - 2021

Y1 - 2021

N2 - PURPOSE: To identify mechanical factors, as well as patients' biometric and surgeons' experience factors that correlate with the FF incidence in microkeratome (MK)-assisted LASIK and to construct a predictive model based on these parameters.METHODS: 55,700 consecutive LASIK treatments of 28,506 patients between January 2017 and April 2020 done by 50 surgeons in 10 centers, all with Sub Bowman Keratome (SBK) and 90μ head (OUP) were analyzed retrospectively for the incidence of FF and their correlation to mean keratometry, central corneal thickness, MK ring height and stop, as well as surgeons' experience. A prediction model was built and tested for sensitivity and specificity.RESULTS: The incidence of FF using the SBK MK was 0.276%. Risk factors were low central corneal thickness, very flat (-1) or very thick (+2) ring height, and higher stop values (p<0.001). Mean keratometry and low surgeon experience were not correlated to FF incidence. A prediction model with a cut-off FF risk of 0.274%, a 76% specificity, and a 73% sensitivity was applied.CONCLUSIONS: Free flaps are rarely seen in modern MK LASIK. However, the incidence of this complication using the SBK MK increases using higher stop values, very thick and very thin MK rings, and in eyes with thin corneas.

AB - PURPOSE: To identify mechanical factors, as well as patients' biometric and surgeons' experience factors that correlate with the FF incidence in microkeratome (MK)-assisted LASIK and to construct a predictive model based on these parameters.METHODS: 55,700 consecutive LASIK treatments of 28,506 patients between January 2017 and April 2020 done by 50 surgeons in 10 centers, all with Sub Bowman Keratome (SBK) and 90μ head (OUP) were analyzed retrospectively for the incidence of FF and their correlation to mean keratometry, central corneal thickness, MK ring height and stop, as well as surgeons' experience. A prediction model was built and tested for sensitivity and specificity.RESULTS: The incidence of FF using the SBK MK was 0.276%. Risk factors were low central corneal thickness, very flat (-1) or very thick (+2) ring height, and higher stop values (p<0.001). Mean keratometry and low surgeon experience were not correlated to FF incidence. A prediction model with a cut-off FF risk of 0.274%, a 76% specificity, and a 73% sensitivity was applied.CONCLUSIONS: Free flaps are rarely seen in modern MK LASIK. However, the incidence of this complication using the SBK MK increases using higher stop values, very thick and very thin MK rings, and in eyes with thin corneas.

KW - Adolescent

KW - Adult

KW - Aged

KW - Astigmatism/surgery

KW - Biometry

KW - Cross-Sectional Studies

KW - Female

KW - Free Tissue Flaps/statistics & numerical data

KW - Germany/epidemiology

KW - Humans

KW - Hyperopia/surgery

KW - Incidence

KW - Keratomileusis, Laser In Situ/adverse effects

KW - Male

KW - Middle Aged

KW - Models, Statistical

KW - Myopia/surgery

KW - Postoperative Complications/epidemiology

KW - Prognosis

KW - Retrospective Studies

KW - Risk Factors

KW - Young Adult

U2 - 10.1371/journal.pone.0255525

DO - 10.1371/journal.pone.0255525

M3 - SCORING: Journal article

C2 - 34469435

VL - 16

JO - PLOS ONE

JF - PLOS ONE

SN - 1932-6203

IS - 9

M1 - e0255525

ER -