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Sub-Bowmans Keratomileusis (SBK)

Thin flap Lasik and "all laser" Lasik details.


Sub-Bowmans Keratomileusis (SBK) is a term used to describe Lasik with a very thin flap to gain advantages of both Lasik and Bladeless Lasik, but also some of the advantages of PRK, LASEK and Epi-Lasik.

A disadvantage of a surface ablation technique like PRK, LASEK, and Epi-Lasik is that the wound response can cause discomfort and delayed vision recovery. Lasik and Bladeless Lasik apply the laser energy under a flap of corneal tissue. By applying the laser energy under this flap, the eye is "fooled" into not realizing it has had surgery and the wound response is muted.

An advantage of a surface ablation technique like PRK, LASEK, and Epi-Lasik is that tissue is disrupted less deep in the cornea, which is believed to contribute to a lower incidence of surgery induced dry eye and provides added stability for thinner corneas.

SBK is an attempt to gain the advantage of the muted wound response found in Lasik and "all laser" Lasik, but also gain the lower incidence of surgery induced dry eye found in PRK, LASEK, and Epi-Lasik and greater stability for thin corneas.

SBK can be performed with conventional or wavefront-guided laser ablation. For details of the process of SBK see Lasik or Bladeless Lasik.

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

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Recent Sub-Bowmans Keratomileusis Medical Journal Articles...

Related Articles

Ultrastructural and three-dimensional study of post-LASIK ectasia cornea.

Microsc Res Tech. 2014 Jan;77(1):91-8

Authors: Akhtar S, Alkatan H, Kirat O, Almubrad T

Abstract
INTRODUCTION: Post-laser in situ keratomileusis (LASIK) corneal ectasia is a serious late postoperative complication. Here, we report the ultrastructural features of the post-LASIK cornea of two patients.
METHODS: Two normal corneas (age 24 and 37 years old) and two post-LASIK ectaic corneas from two patients (A and B) were studied. The "patient A" (age 27 years) underwent penetrating keratoplasty and "patient B" (age 31 years) underwent deep-anterior lamellar keratoplasty. The excised corneas were processed for light and electron microscopy. A total of 120 images for three-dimensional (3D) reconstruction were taken by using the software "Recorder" and using a bottom mounted camera "Quemesa" attached to a JOEL 1400 transmission electron microscope. The 3D images were constructed using "Visual Kai" software.
RESULTS: In the post-LASIK cornea, the hemidesmosomes, the basement membrane, and Bowman"s layer were abnormal. The stromal lamellae were thin and disorganized. The collagen fibrils (CFs) diameter and interfibrillar spacing had decreased. Aggregated microfibrils were present in the Bowman's layer and all parts of the stroma. A large number of microfilaments were present at the detachment end of the flap and residual stroma. The 3D images showed the presence of collagen microfibrils and proteoglycans (PGs) within the CF of the normal and post-LASIK cornea. The collagen microfibrils and PGs within the CFs had degenerated in the post-LASIK cornea.
CONCLUSION: Collagen microfibrils and PGs within the CFs were degenerated, leading to the degeneration of CFs, followed by the disorganization of lamellae in post-LASIK cornea. The CFs diameter and interfibrillar spacing decreased.

PMID: 24222271 [PubMed - indexed for MEDLINE]

 


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