Vergleich der Mikrokeratome Amadeus II und Hansatom hinsichtlich Komplikationen und funktionellem Ergebnis nach LASIK : eine retrospektive Studie

INTRODUCTION: Today LASIK is the most common method in refractive surgery. In classical LASIK preparation of the flap is done mechanically by a microkeratome, of which meanwhile there are many different types. The aim of this study is a comparison of the two common Microkeratomes Amadeus II from Ziemer Ophthalmic Systems AG and Hansatome from Bausch & Lomb concerning postoperative vision, refraction and complications. MATERIAL AND METHODS: 2 groups of 40 patients each were retrospectively examined. In one group, patients received treatment using the Amadeus II, in the other group by using the Hansatome, all other conditions were identical. The Zyoptix 217z 100 was used as excimer laser. Visual acuity, refractive error and complications were acquired on 3 consecutive examinations: first popstoperative day, 1-3 weeks postoperative and 6-10 weeks postoperative. Visual acquity was transformed into logMar for statistical processing. RESULTS: UCVA: after 1-3 weeks mean visual aqcuity in the Amadeus group was significantly better (p=0,006) than in the Hansatome group with 0,06 vs 0,11. 0,06 vs 0,04 after 6-10 weeks, but without statistical significance. Refractive error: After 6-10 weeks, there was less spherical error in the Hansatome group than in the Amadeus group, by a narrow margin not significantly (p=0,06): -0,214 vs -0,04. After 1-3 weeks there was significantly (p=0,001) lower remaining atigmatism in the Amadeus: -0,48 vs -0,64. Complications: There were no severe complications like cutting problems and macrostriae in both groups. During the operation there was much more loosening of the epithelial layer in the Amadeus group: 10 vs 0, also there were 2 cases of implantation of epithelial cells in the interface after 6-10 weeks vs 0 in the Hansatome group. DLK stage I was observed 2 times after 1-3 weeks in the Amadeus group, after 6-10 weeks there was no case of DLK in both groups. Dry eye was more common in the Hansatome group after 6-10 weeks: 2 vs 6 times, however in the precedant examinations it was more common in the Amadeus group. CONCLUSIONS: Differences between both microkeratomes were minimal. At the end of the observation period functional results in the Hansatome group were a bit better, while the Amadeus microkeratome seems to generate less sicca symptoms; the reason for this might be the nasal hinge position of the Amadeus microkeratome which might spare the nasal corneal nerves