Air-Bubble Migration Patterns During Femtosecond LASIK Flap Creation
Narrative Responses:
Purpose
To describe the migration pattern of cavitation bubbles into the anterior chamber following femtosecond LASIK-flap creation.
Methods
Retrospective review of all patients undergoing femtosecond laser-assisted LASIK surgery between January 2010 and September 2013 at the Boston Eye Group. Surgical videos of patients with anterior chamber air bubble migration were reviewed. The first appearance of bubbles in the anterior chamber (AC) was recorded by clock hour separately for right and left eyes.
Results
4272 eyes from 2136 patients received femtosecond laser-assisted LASIK surgery. Air bubble migration into the AC, presumably via the canal of Schlemm (SC) and trabecular meshwork (TM), occurred in 33 eyes (0.8%) of 28 patients. In these cases, gas bubbles first appeared in the nasal hemisection in 94.4 % of right eyes and 92.8% of left eyes. Gas bubbles first appeared in the temporal hemisection in 5.6% and 7.2% of right and left eyes, respectively.
Conclusion
The preferential migration of gas bubbles into nasal hemisection of the anterior chamber indicates either a distinctive anatomy of the nasal SC or an artifact from the intentional temporal decentration of the suction ring.