In vivo structural characteristics of the femtosecond LASIK-induced opaque bubble layers with ultrahigh-resolution SD-OCT.

The authors report in vivo morphology of opaque bubble layers with ultrahigh-resolution anterior-segment optical coherence tomography (UHR-OCT) in 3 patients. Two patients were operated on with a 30-kHz IntraLase femtosecond laser (Abbott Medical Optics, Abbott Park, IL) and one patient was operated on with a 500-kHz VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany). UHR-OCT images from the patient operated on with the 500-kHz femtosecond laser revealed that the opaque bubble layer extended anterior to the flap dissection plane up to Bowman's membrane. The lamellar flap dissection was incomplete in this patient. The opaque bubble layer in the patients operated on with the 30-kHz femtosecond laser extended posterior to the flap dissection plane and these patients experienced complete lamellar dissections with uncomplicated flap lifts. UHR-OCT imaging can be used to demonstrate the structural characteristics of OBL. It has the potential to be used to predict incomplete lamellar flap dissections in patients with opaque bubble layers.