1. LASIK with thin flaps using the Moria One Use-Plus microkeratome with the 130 disposable heads
Jérôme C. VRYGHEM, M.D.
Brussels Eye Doctors
Brussels, Belgium
No financial interest

2. Advantages of Thin Flaps
Cut through more superficial layers of the cornea
More solid texture: less tendency to form tension lines/wrinkle
The large corneal nerves trunks are below:
corneal sensation – more intact
less dry eyes
Less epithelial defects
The thinner the flap, the less epithelial trauma
Plastic is more gently to the epithelium
Thicker residual corneal bed
Greater safety: Further away from the 250 µm ectasia barrier
More possibilities:
Thinner corneas can be treated
Larger optical zones if needed can be treated
Enhancements still possible without going too thin

3. Moria One Use-Plus keratome
with metal ring
Ergonomic, pre-assembled and one-handed usage possible
Metal suction ring
4 stops (7.5, 8, 8.5, 9) to change hinge size
4 metal ring sizes to fit all keratometries (-1, 0, +1, +2)
2 motors, one for blade oscillation, one for advancement

4. Moria One Use-Plus keratome
Single Use heads
Sterile device
Potentially lower incidence of DLK
Decreases risk of transmission of disease
Translucent head
Makes it easier to visualize placement on the suction post
Easy to assemble
No risk of blade damage during assembly
130 head
(for 130-µm flaps)

5. Settings One Use Plus with 130 head and metal ring
One surgeon: Dr. J. C. Vryghem
Private clinic: Brussels Eye Doctors
Wavelight Allegreto laser for excimer ablation
Prospective study in 68 eyes of 34 patients
2 months in 2007

6. Methods One Use Plus with 130 head and metal ring
Flap thickness by subtractive pachymetry
Flap dimensions measured with calipers
Complications reported intraop and postop

7. Results Flap Thickness
One Use Plus with 130 head and metal ring
Microkeratome head
Speed
Average Thickness
Range
130 µ
2 (Fast)
123 +/- 12 µ
97 to 149 µ

8. Results Flap Thickness versus Preop pachymetry
Flap thickness (microns)
Preop pachymetry (microns) n =68

9. Results Vertical Flap Diameter Hinge size
One Use Plus with 130 head and metal ring
9.9 mm ± 0.25
min 9.0
max 10.25
5.11 mm ± 0.56
min 4
max 6.5
Flap Diameter
Hinge size

10. Results Complications
Button-hole
Free cap
Irregular flap
Thin flap requiring BCL
Epithelial sloughing
DLK
Epithelial ingrowth
Microstriae
Bleeding 3 25

11. Results Flap and bed quality
28/68 eyes
Centration 95 % excellent
Edge quality 60 % excellent
Shape of the flap 100 % excellent
Bed quality 96 % excellent

12. Moria One Use Plus with metal head
Conclusion
Moria One Use Plus with metal head
My keratome of choice in LASIK
Excellent flap thickness predictability
Excellent safety profile
Ongoing study with 90 Head