ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2023
VisuMax Flap 2.0: a flap plus technique to reduce incidence of an opaque bubble layer in femtosecond laser-assisted LASIK.
Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 4 citations in OpenAlex.
- Preoperative predictive factors for opaque bubble layer formation and area during small-incision lenticule extraction: predictive models based on machine learning.Eye and vision (London, England) · 2026Article
- Comparison of risk factors for OBL in FS-LASIK and SMILE correction for myopia and myopia astigmatism.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2024Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
purposeTo evaluate the incidence of an opaque bubble layer (OBL) in femtosecond laser-assisted in situ keratomileusis (FS-LASIK) flaps created with VisuMax Flap 2.0 as a result of a modification in the parameters of the flap programming.
methodsThis retrospective study was comprised of 1400 eyes of 715 patients who received FS-LASIK surgery. OBLs were measured and reported as a percentage of the flap area to identify the incidence and extent. Flap creation, which is a modification technique, was performed with 8.1-mm flap diameters plus 0.3-mm enlarged interlamellar photodisruption (group Flap 2.0). The same flap diameters without extra photodisruption as the previous standard setting were also implemented (group Flap 1.0). The preoperative measurements, including sphere, cylinder, keratometry, and intraoperative characteristics such as flap size and thickness, were documented. Possible risk factors for the occurrence of OBLs were investigated in this study.
resultsThe incidence of an OBL was reduced when using the Flap 2.0 program (31.4%) compared to the Flap 1.0 program (63.7%). The area of hard and soft OBLs created by the Flap 2.0 program is smaller than those created by the Flap 1.0 program (P = 0.007 and P < 0.001). Multivariate logistic regression indicated that a thinner flap (P = 0.038) and a higher sphere (P = 0.001) affected the chance of hard OBLs occurring.
conclusionThe VisuMax Flap 2.0 program promotes gas venting by enlarging the interlamellar photodisruption size. The incidence and extent of OBLs appear to be reduced significantly when the Flap 2.0 program is applied.
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