Flap results obtained with latest-generation femtosecond lasers should strictly be compared with latest-generation automated microkeratomes. The trend in laser vision correction is a thin flap, and there is now evidence to suggest that the One Use-Plus SBK microkeratome (Moria, Antony, France) is a safe and effective modality for sub-Bowman keratomileusis (SBK).1-6
Microkeratome technology has evolved, and today's designs are automated to achieve reproducible results that are equivalent to those of femtosecond lasers. Norden et al1 prospectively studied results of 100 eyes from 50 consecutive myopic patients, half of whom were treated with the One Use-Plus SBK microkeratome and the other half with the IntraLase 60-kHz femtosecond laser (Abbott Medical Optics Inc., Santa Ana, California). Both devices were used to create approximately 100-µm flaps, with similar predictability, accuracy, and results. The difference was, Norden noted, that the One Use-Plus SBK was associated with fewer complications, less discomfort, and faster visual recovery. Additionally, Vejarano et al2 showed that both the flap and stromal bed were smooth and of excellent quality in 1,363 eyes that underwent SBK with the One Use-Plus.
According to Lewis et al,3 the One Use-Plus SBK microkeratome creates a flap profile that is semi-planar. Results from more than 400 consecutive corneal flaps indicated that the average central corneal flap was 99 ±8 µm in the right eye and 97 ±m in the left (range, 80–120 µm), with nasal and temporal flap thickness measuring between 104 and 115 µm. Casado et al4 studied 1,350 eyes that underwent flap creation with the One Use- Plus SBK and concluded that the average central flap thickness was 100.48 ± 12.77 µm (range, 74–130); the average vertical flap diameter was 9.26 ±0.34 mm. Anterior segment ocular coherence tomography showed all flaps were planar in shape, with no complications or defective flaps.
SBK is currently thought to achieve excellent results. According to the literature, the One Use-Plus SBK microkeratome produces planar and consistent flaps, with an average thickness of 100 µm and a tight standard deviation.5 These outcomes are consistent with results with the latest generation of femtosecond lasers.