Comparison of Flap Thickness Measured with Ultrasound Subtraction Method, Direct Method, and Optical Coherence Tomography

ABSTRACT

PURPOSE: To compare the flap thicknesses measured with the ultrasound (US) subtraction method, the direct method, and optical coherence tomography (OCT) in femtosecond laser-assisted LASIK eyes. METHODS: The present study included 65 eyes of 37 patients who underwent femtosecond laser-assisted LASIK surgery. Flap thickness was measured intraoperatively using the direct and subtraction methods with US pachymetry and postoperatively using anterior segment OCT. Flap thickness measurements were compared among the three methods. RESULTS: There was no significant difference between the flap thickness measured using the US subtraction method and OCT (p = 0.511). The flap thickness values obtained by these two different methods also correlated well with each other (gamma = 0.820, p < 0.001). However, flap thickness measured using the US direct method was significantly different (p < 0.001) with a low agreement value compared to the other two methods. Furthermore, the US direct method showed a lower measurement success rate compared to the US subtraction method (54% vs. 95%). CONCLUSIONS: Flap thickness measured using the US subtraction method and OCT showed different values compared to that measured using the US direct method. Because of the lower measurement success rate and agreement value, the US direct method is not capable of being used in substitute for the US subtraction method.