The Impact of Flap Creation Methods for Sub-Bowman’s Keratomileusis (SBK) on the Central Thickness of Bowman’s Layer
To determine the impact of flap creation methods for sub-Bowman's keratomileusis (SBK) on central Bowman's layer thickness. SBK flaps were made by Moria microkeratome for 20 subjects and by femtosecond (FEMTO) laser for 21 subjects. Corneal sublayer thicknesses were measured by ultra-high...
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| Vydané v: | PloS one Ročník 10; číslo 5; s. e0124996 |
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| Hlavní autori: | , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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United States
Public Library of Science
04.05.2015
Public Library of Science (PLoS) |
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| ISSN: | 1932-6203, 1932-6203 |
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| Abstract | To determine the impact of flap creation methods for sub-Bowman's keratomileusis (SBK) on central Bowman's layer thickness.
SBK flaps were made by Moria microkeratome for 20 subjects and by femtosecond (FEMTO) laser for 21 subjects. Corneal sublayer thicknesses were measured by ultra-high resolution optical coherence tomography before SBK and at 1 day, 1 week, 2 weeks, and 1 month afterwards. Each subject was imaged twice on each visit. Thicknesses of central epithelium, Bowman's layer, flap, and total cornea were calculated using a custom-made automated image processing algorithm. The repeatability of sublayer thickness measurements was tested by the intraclass correlation coefficient (ICC) and by the coefficient of repeatability (CoR) at 1 week post-SBK.
ICCs of the Moria and FEMTO groups were ≥ 0.959 and ≥ 0.961 respectively for all sublayer measurements. The segmentation CoRs were less than 6.78% and 5.63% respectively. For both groups, microdistortions were present in the epithelium and Bowman's layer after SKB. The flap thickness of the Moria group was 9.8 μm (95% confidence interval: 4.8 - 14.8 μm) thinner than the FEMTO group one day after SBK (independent samples t-test, P < 0.05). Bowman's layer became thicker by 1.6 ± 1.1 μm and 1.7 ± 1.6 μm one day post-SBK for the Moria and FEMTO groups (repeated ANOVA, P < 0.05) and then remained stable. Corneal and sublayer thickness were similar between the two groups.
Central Bowman's layer thickness increased 1 day post-SBK. Flap creation by Moria microkeratome and femtosecond laser did not have significantly different impacts on Bowman's layer thickness following SBK.
Chinese Clinical Trial Registry (ChiCTR) NO: ChiCTR-OCH-14004525. |
|---|---|
| AbstractList | Purpose
To determine the impact of flap creation methods for sub-Bowman’s keratomileusis (SBK) on central Bowman’s layer thickness.
Methods
SBK flaps were made by Moria microkeratome for 20 subjects and by femtosecond (FEMTO) laser for 21 subjects. Corneal sublayer thicknesses were measured by ultra-high resolution optical coherence tomography before SBK and at 1 day, 1 week, 2 weeks, and 1 month afterwards. Each subject was imaged twice on each visit. Thicknesses of central epithelium, Bowman’s layer, flap, and total cornea were calculated using a custom-made automated image processing algorithm. The repeatability of sublayer thickness measurements was tested by the intraclass correlation coefficient (ICC) and by the coefficient of repeatability (CoR) at 1 week post-SBK.
Results
ICCs of the Moria and FEMTO groups were ≥0.959 and ≥0.961 respectively for all sublayer measurements. The segmentation CoRs were less than 6.78% and 5.63% respectively. For both groups, microdistortions were present in the epithelium and Bowman’s layer after SKB. The flap thickness of the Moria group was 9.8 μm (95% confidence interval: 4.8 – 14.8μm) thinner than the FEMTO group one day after SBK (independent samples t-test, P < 0.05). Bowman’s layer became thicker by 1.6 ± 1.1 μm and 1.7 ± 1.6 μm one day post-SBK for the Moria and FEMTO groups (repeated ANOVA, P < 0.05) and then remained stable. Corneal and sublayer thickness were similar between the two groups.
Conclusions
Central Bowman’s layer thickness increased 1 day post-SBK. Flap creation by Moria microkeratome and femtosecond laser did not have significantly different impacts on Bowman’s layer thickness following SBK.
Trial Registration
Chinese Clinical Trial Registry (ChiCTR) NO: ChiCTR-OCH-14004525 To determine the impact of flap creation methods for sub-Bowman's keratomileusis (SBK) on central Bowman's layer thickness. SBK flaps were made by Moria microkeratome for 20 subjects and by femtosecond (FEMTO) laser for 21 subjects. Corneal sublayer thicknesses were measured by ultra-high resolution optical coherence tomography before SBK and at 1 day, 1 week, 2 weeks, and 1 month afterwards. Each subject was imaged twice on each visit. Thicknesses of central epithelium, Bowman's layer, flap, and total cornea were calculated using a custom-made automated image processing algorithm. The repeatability of sublayer thickness measurements was tested by the intraclass correlation coefficient (ICC) and by the coefficient of repeatability (CoR) at 1 week post-SBK. ICCs of the Moria and FEMTO groups were ≥ 0.959 and ≥ 0.961 respectively for all sublayer measurements. The segmentation CoRs were less than 6.78% and 5.63% respectively. For both groups, microdistortions were present in the epithelium and Bowman's layer after SKB. The flap thickness of the Moria group was 9.8 μm (95% confidence interval: 4.8 - 14.8 μm) thinner than the FEMTO group one day after SBK (independent samples t-test, P < 0.05). Bowman's layer became thicker by 1.6 ± 1.1 μm and 1.7 ± 1.6 μm one day post-SBK for the Moria and FEMTO groups (repeated ANOVA, P < 0.05) and then remained stable. Corneal and sublayer thickness were similar between the two groups. Central Bowman's layer thickness increased 1 day post-SBK. Flap creation by Moria microkeratome and femtosecond laser did not have significantly different impacts on Bowman's layer thickness following SBK. Chinese Clinical Trial Registry (ChiCTR) NO: ChiCTR-OCH-14004525. Purpose To determine the impact of flap creation methods for sub-Bowman’s keratomileusis (SBK) on central Bowman’s layer thickness. Methods SBK flaps were made by Moria microkeratome for 20 subjects and by femtosecond (FEMTO) laser for 21 subjects. Corneal sublayer thicknesses were measured by ultra-high resolution optical coherence tomography before SBK and at 1 day, 1 week, 2 weeks, and 1 month afterwards. Each subject was imaged twice on each visit. Thicknesses of central epithelium, Bowman’s layer, flap, and total cornea were calculated using a custom-made automated image processing algorithm. The repeatability of sublayer thickness measurements was tested by the intraclass correlation coefficient (ICC) and by the coefficient of repeatability (CoR) at 1 week post-SBK. Results ICCs of the Moria and FEMTO groups were ≥0.959 and ≥0.961 respectively for all sublayer measurements. The segmentation CoRs were less than 6.78% and 5.63% respectively. For both groups, microdistortions were present in the epithelium and Bowman’s layer after SKB. The flap thickness of the Moria group was 9.8 μm (95% confidence interval: 4.8 – 14.8μm) thinner than the FEMTO group one day after SBK (independent samples t-test, P < 0.05). Bowman’s layer became thicker by 1.6 ± 1.1 μm and 1.7 ± 1.6 μm one day post-SBK for the Moria and FEMTO groups (repeated ANOVA, P < 0.05) and then remained stable. Corneal and sublayer thickness were similar between the two groups. Conclusions Central Bowman’s layer thickness increased 1 day post-SBK. Flap creation by Moria microkeratome and femtosecond laser did not have significantly different impacts on Bowman’s layer thickness following SBK. Trial Registration Chinese Clinical Trial Registry (ChiCTR) NO: ChiCTR-OCH-14004525 To determine the impact of flap creation methods for sub-Bowman's keratomileusis (SBK) on central Bowman's layer thickness.PURPOSETo determine the impact of flap creation methods for sub-Bowman's keratomileusis (SBK) on central Bowman's layer thickness.SBK flaps were made by Moria microkeratome for 20 subjects and by femtosecond (FEMTO) laser for 21 subjects. Corneal sublayer thicknesses were measured by ultra-high resolution optical coherence tomography before SBK and at 1 day, 1 week, 2 weeks, and 1 month afterwards. Each subject was imaged twice on each visit. Thicknesses of central epithelium, Bowman's layer, flap, and total cornea were calculated using a custom-made automated image processing algorithm. The repeatability of sublayer thickness measurements was tested by the intraclass correlation coefficient (ICC) and by the coefficient of repeatability (CoR) at 1 week post-SBK.METHODSSBK flaps were made by Moria microkeratome for 20 subjects and by femtosecond (FEMTO) laser for 21 subjects. Corneal sublayer thicknesses were measured by ultra-high resolution optical coherence tomography before SBK and at 1 day, 1 week, 2 weeks, and 1 month afterwards. Each subject was imaged twice on each visit. Thicknesses of central epithelium, Bowman's layer, flap, and total cornea were calculated using a custom-made automated image processing algorithm. The repeatability of sublayer thickness measurements was tested by the intraclass correlation coefficient (ICC) and by the coefficient of repeatability (CoR) at 1 week post-SBK.ICCs of the Moria and FEMTO groups were ≥ 0.959 and ≥ 0.961 respectively for all sublayer measurements. The segmentation CoRs were less than 6.78% and 5.63% respectively. For both groups, microdistortions were present in the epithelium and Bowman's layer after SKB. The flap thickness of the Moria group was 9.8 μm (95% confidence interval: 4.8 - 14.8 μm) thinner than the FEMTO group one day after SBK (independent samples t-test, P < 0.05). Bowman's layer became thicker by 1.6 ± 1.1 μm and 1.7 ± 1.6 μm one day post-SBK for the Moria and FEMTO groups (repeated ANOVA, P < 0.05) and then remained stable. Corneal and sublayer thickness were similar between the two groups.RESULTSICCs of the Moria and FEMTO groups were ≥ 0.959 and ≥ 0.961 respectively for all sublayer measurements. The segmentation CoRs were less than 6.78% and 5.63% respectively. For both groups, microdistortions were present in the epithelium and Bowman's layer after SKB. The flap thickness of the Moria group was 9.8 μm (95% confidence interval: 4.8 - 14.8 μm) thinner than the FEMTO group one day after SBK (independent samples t-test, P < 0.05). Bowman's layer became thicker by 1.6 ± 1.1 μm and 1.7 ± 1.6 μm one day post-SBK for the Moria and FEMTO groups (repeated ANOVA, P < 0.05) and then remained stable. Corneal and sublayer thickness were similar between the two groups.Central Bowman's layer thickness increased 1 day post-SBK. Flap creation by Moria microkeratome and femtosecond laser did not have significantly different impacts on Bowman's layer thickness following SBK.CONCLUSIONSCentral Bowman's layer thickness increased 1 day post-SBK. Flap creation by Moria microkeratome and femtosecond laser did not have significantly different impacts on Bowman's layer thickness following SBK.Chinese Clinical Trial Registry (ChiCTR) NO: ChiCTR-OCH-14004525.TRIAL REGISTRATIONChinese Clinical Trial Registry (ChiCTR) NO: ChiCTR-OCH-14004525. To determine the impact of flap creation methods for sub-Bowman's keratomileusis (SBK) on central Bowman's layer thickness. SBK flaps were made by Moria microkeratome for 20 subjects and by femtosecond (FEMTO) laser for 21 subjects. Corneal sublayer thicknesses were measured by ultra-high resolution optical coherence tomography before SBK and at 1 day, 1 week, 2 weeks, and 1 month afterwards. Each subject was imaged twice on each visit. Thicknesses of central epithelium, Bowman's layer, flap, and total cornea were calculated using a custom-made automated image processing algorithm. The repeatability of sublayer thickness measurements was tested by the intraclass correlation coefficient (ICC) and by the coefficient of repeatability (CoR) at 1 week post-SBK. ICCs of the Moria and FEMTO groups were [greater than or equal to]0.959 and [greater than or equal to]0.961 respectively for all sublayer measurements. The segmentation CoRs were less than 6.78% and 5.63% respectively. For both groups, microdistortions were present in the epithelium and Bowman's layer after SKB. The flap thickness of the Moria group was 9.8 [mu]m (95% confidence interval: 4.8 - 14.8[mu]m) thinner than the FEMTO group one day after SBK (independent samples t-test, P < 0.05). Bowman's layer became thicker by 1.6 ± 1.1 [mu]m and 1.7 ± 1.6 [mu]m one day post-SBK for the Moria and FEMTO groups (repeated ANOVA, P < 0.05) and then remained stable. Corneal and sublayer thickness were similar between the two groups. Central Bowman's layer thickness increased 1 day post-SBK. Flap creation by Moria microkeratome and femtosecond laser did not have significantly different impacts on Bowman's layer thickness following SBK. Purpose To determine the impact of flap creation methods for sub-Bowman's keratomileusis (SBK) on central Bowman's layer thickness. Methods SBK flaps were made by Moria microkeratome for 20 subjects and by femtosecond (FEMTO) laser for 21 subjects. Corneal sublayer thicknesses were measured by ultra-high resolution optical coherence tomography before SBK and at 1 day, 1 week, 2 weeks, and 1 month afterwards. Each subject was imaged twice on each visit. Thicknesses of central epithelium, Bowman's layer, flap, and total cornea were calculated using a custom-made automated image processing algorithm. The repeatability of sublayer thickness measurements was tested by the intraclass correlation coefficient (ICC) and by the coefficient of repeatability (CoR) at 1 week post-SBK. Results ICCs of the Moria and FEMTO groups were [greater than or equal to]0.959 and [greater than or equal to]0.961 respectively for all sublayer measurements. The segmentation CoRs were less than 6.78% and 5.63% respectively. For both groups, microdistortions were present in the epithelium and Bowman's layer after SKB. The flap thickness of the Moria group was 9.8 [mu]m (95% confidence interval: 4.8 - 14.8[mu]m) thinner than the FEMTO group one day after SBK (independent samples t-test, P < 0.05). Bowman's layer became thicker by 1.6 ± 1.1 [mu]m and 1.7 ± 1.6 [mu]m one day post-SBK for the Moria and FEMTO groups (repeated ANOVA, P < 0.05) and then remained stable. Corneal and sublayer thickness were similar between the two groups. Conclusions Central Bowman's layer thickness increased 1 day post-SBK. Flap creation by Moria microkeratome and femtosecond laser did not have significantly different impacts on Bowman's layer thickness following SBK. Trial Registration Chinese Clinical Trial Registry (ChiCTR) NO: ChiCTR-OCH-14004525 PurposeTo determine the impact of flap creation methods for sub-Bowman's keratomileusis (SBK) on central Bowman's layer thickness.MethodsSBK flaps were made by Moria microkeratome for 20 subjects and by femtosecond (FEMTO) laser for 21 subjects. Corneal sublayer thicknesses were measured by ultra-high resolution optical coherence tomography before SBK and at 1 day, 1 week, 2 weeks, and 1 month afterwards. Each subject was imaged twice on each visit. Thicknesses of central epithelium, Bowman's layer, flap, and total cornea were calculated using a custom-made automated image processing algorithm. The repeatability of sublayer thickness measurements was tested by the intraclass correlation coefficient (ICC) and by the coefficient of repeatability (CoR) at 1 week post-SBK.ResultsICCs of the Moria and FEMTO groups were ≥ 0.959 and ≥ 0.961 respectively for all sublayer measurements. The segmentation CoRs were less than 6.78% and 5.63% respectively. For both groups, microdistortions were present in the epithelium and Bowman's layer after SKB. The flap thickness of the Moria group was 9.8 μm (95% confidence interval: 4.8 - 14.8 μm) thinner than the FEMTO group one day after SBK (independent samples t-test, P < 0.05). Bowman's layer became thicker by 1.6 ± 1.1 μm and 1.7 ± 1.6 μm one day post-SBK for the Moria and FEMTO groups (repeated ANOVA, P < 0.05) and then remained stable. Corneal and sublayer thickness were similar between the two groups.ConclusionsCentral Bowman's layer thickness increased 1 day post-SBK. Flap creation by Moria microkeratome and femtosecond laser did not have significantly different impacts on Bowman's layer thickness following SBK.Trial registrationChinese Clinical Trial Registry (ChiCTR) NO: ChiCTR-OCH-14004525. |
| Audience | Academic |
| Author | Xu, Zhe Qu, Jia Hu, Di Liu, Jing Wang, Jianhua Hu, Liang Peng, Mei Lu, Fan Zhuang, Xiran Shen, Meixiao |
| AuthorAffiliation | Medical University of South Carolina, UNITED STATES 2 Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America 1 School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China |
| AuthorAffiliation_xml | – name: 2 Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, United States of America – name: 1 School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China – name: Medical University of South Carolina, UNITED STATES |
| Author_xml | – sequence: 1 givenname: Zhe surname: Xu fullname: Xu, Zhe – sequence: 2 givenname: Meixiao surname: Shen fullname: Shen, Meixiao – sequence: 3 givenname: Liang surname: Hu fullname: Hu, Liang – sequence: 4 givenname: Xiran surname: Zhuang fullname: Zhuang, Xiran – sequence: 5 givenname: Mei surname: Peng fullname: Peng, Mei – sequence: 6 givenname: Di surname: Hu fullname: Hu, Di – sequence: 7 givenname: Jing surname: Liu fullname: Liu, Jing – sequence: 8 givenname: Jianhua surname: Wang fullname: Wang, Jianhua – sequence: 9 givenname: Jia surname: Qu fullname: Qu, Jia – sequence: 10 givenname: Fan surname: Lu fullname: Lu, Fan |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25938492$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_3389_fmed_2021_731462 |
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| Copyright | COPYRIGHT 2015 Public Library of Science 2015 Xu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2015 Xu et al 2015 Xu et al |
| Copyright_xml | – notice: COPYRIGHT 2015 Public Library of Science – notice: 2015 Xu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: 2015 Xu et al 2015 Xu et al |
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| DOI | 10.1371/journal.pone.0124996 |
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| DocumentTitleAlternate | Bowman's Layer Thickness Changes after SBK |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Article-2 ObjectType-Feature-1 content type line 23 Competing Interests: The authors have declared that no competing interests exist. Conceived and designed the experiments: ZX MS LH JW JQ FL. Performed the experiments: ZX MS LH XZ MP JL JW JQ FL. Analyzed the data: ZX MS LH XZ MP JL. Contributed reagents/materials/analysis tools: ZX MS LH XZ MP JL. Wrote the paper: ZX MS LH XZ MP DH JL JW JQ FL. These authors are co-first authors on this work. |
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| Snippet | To determine the impact of flap creation methods for sub-Bowman's keratomileusis (SBK) on central Bowman's layer thickness.
SBK flaps were made by Moria... Purpose To determine the impact of flap creation methods for sub-Bowman's keratomileusis (SBK) on central Bowman's layer thickness. Methods SBK flaps were made... To determine the impact of flap creation methods for sub-Bowman's keratomileusis (SBK) on central Bowman's layer thickness. SBK flaps were made by Moria... Purpose To determine the impact of flap creation methods for sub-Bowman’s keratomileusis (SBK) on central Bowman’s layer thickness. Methods SBK flaps were made... To determine the impact of flap creation methods for sub-Bowman's keratomileusis (SBK) on central Bowman's layer thickness.PURPOSETo determine the impact of... PurposeTo determine the impact of flap creation methods for sub-Bowman's keratomileusis (SBK) on central Bowman's layer thickness.MethodsSBK flaps were made by... Purpose To determine the impact of flap creation methods for sub-Bowman’s keratomileusis (SBK) on central Bowman’s layer thickness. Methods SBK flaps were made... |
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| SubjectTerms | Adult Astigmatism Bowman Membrane - pathology Bowman Membrane - surgery Care and treatment Cataracts Clinical trials Complications and side effects Confidence intervals Cornea Corneal diseases Correlation coefficient Correlation coefficients Epithelium Epithelium, Corneal - pathology Epithelium, Corneal - surgery Female Femtosecond Femtosecond lasers Flaps Humans Image processing Image Processing, Computer-Assisted Image segmentation Keratomileusis, Laser In Situ Lasers Male Methods Microscopy Optical Coherence Tomography Optometry Reproducibility Reproducibility of Results Researchers Segmentation Studies Surgery Surgical Flaps Thickness measurement Tomography Tomography, Optical Coherence Ultrasonic imaging Variance analysis Wound healing |
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| Title | The Impact of Flap Creation Methods for Sub-Bowman’s Keratomileusis (SBK) on the Central Thickness of Bowman’s Layer |
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