The planar configuration of the femtosecond laser flap offers no advantage in corneal higher-order aberrations or visual acuity after LASIK, reports a recent study. Authors of the prospective, randomized, paired-eye study compared corneal higher-order aberrations and visual acuity after LASIK with the flap created by a femtosecond laser to LASIK with a flap that was created using a mechanical microkeratome. Fellow eyes of 21 patients with myopia or myopic astigmatism were randomized by ocular dominance. Both corneal topography and visual acuity were measured before and at one, three, six, 12 and 36 months after LASIK. Wavefront errors from the anterior corneal surface were calculated from the topography data for pupils that measured 4 and 6 mm in diameter and decomposed into Zernike polynomials to the 6th order.

The results did not show any differences in corneal total higher-order aberrations, spherical aberration, coma or trefoil between the two methods of flap creation at any examination for pupils 4 and 6 mm in diameter. For a 6-mm pupil, total higher-order aberrations increased by one month after LASIK with both treatments (p¡Ü0.001) and remained increased through 36 months (p¡Ü0.001). Uncorrected and best-corrected visual acuity did not differ between the two methods at any examination and remained stable postoperatively through three years; the minimum detectable difference in visual acuity between treatments was ¡Ü0.1 logMAR (¡Ü one line of vision, alpha=0.05/6, beta=0.20, n=21).

Am J Ophthalmol 2010;149:785-93.

Calvo R, McLaren JW, Hodge DO, et al.

Fibrin Adhesive Trumps Sutures in Pterygium Surgery

New research has shown that using fibrin adhesive in primary pterygium surgery with conjunctival autografts instead of sutures reduces recurrence rate, surgical time and postoperative pain. To test this, a prospective, randomized, double-blind clinical trial was developed to observe the benefits of using fibrin adhesive in place of sutures in pterygium surgery. One hundred seventy-five eyes with primary pterygium were randomized to undergo pterygium surgery with conjunctival autograft transplantation using either fibrin adhesive or sutures. One hundred thirty-seven eyes of 113 patients who were operated on by a single surgeon completed the one-year follow-up. Sixty-eight eyes were operated on with fibrin adhesive and 69 eyes with sutures. Patients were followed up at one day, one week, one month, six months and one year after surgery. Pterygium recurrence and postoperative pain was graded by an independent observer who was masked to the method of treatment. Surgical time was measured with a stopwatch.

At one-year follow-up, there were three recurrences (4.41 percent) in the fibrin adhesive group and 11 recurrences (15.9 percent) in the suture group. The mean duration required to complete surgery in the fibrin adhesive group was 16.93 +2.85 minutes, whereas that of the suture group was 29.84 +5.65 minutes, which was statistically significant (p<0.001). The immediate postoperative pain score and week-one postoperative pain score were significantly lower in the fibrin adhesive group (p<0.05). No major complications were observed in either group.

Cornea 2010;29:485-9.

Ratnalingam V, Eu AL, Ng GL, et al.