PURPOSE To present the incidence, risk factors, and effect of opaque bubble layer (OBL) formation during flap creation in laser-assisted in situ keratomileusis (LASIK) with a 500-kHz femtosecond laser on visual performance. METHODS In this retrospective study, preoperative characteristics (age, sex, keratometric value, spherical equivalent, and central corneal thickness) and intraoperative surgical factors (used energy, docking type, and flap thickness) were compared between eyes with and without OBL formation during flap creation. Possible risk factors for specific types of OBLs were analyzed. RESULTS One hundred thirty-five eyes of 71 patients underwent LASIK, and OBL developed in 98 eyes (72.59%). In the univariate analysis, the greater than 80-µm flap group was associated with a lower OBL occurrence than the 80-µm flap group (P = .0424, odds ratio [OR] = 0.481) and hard docking was associated with increased OBL formation (P = .0001, OR = 6.859). In the multivariate analysis, hard docking was a risk factor for OBL development (P = .0003, OR = 6.329). In the subgroup analysis, hard docking had a marginal effect on OBL occurrence in the 80-µm flap group (P = .086, OR = 3.564), but it had a strong effect in the greater than 80-µm flap group (P = .0018, OR = 10.210). CONCLUSIONS Hard docking is a risk factor for OBL development. However, hard docking had a small effect on OBL occurrence in the 80-µm flap group during LASIK. OBL formation did not affect visual performance. [J Refract Surg. 2019;35(9):583-589.].

中文翻译：

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在500 kHz FS-LASIK中根据瓣厚度形成不透明气泡层的发生率和危险因素。

目的介绍使用500 kHz飞秒激光在激光辅助原位角膜磨镶术（LASIK）的皮瓣制造过程中皮瓣形成过程中发生不透明气泡层（OBL）的发生率，危险因素和影响。方法在这项回顾性研究中，比较了皮瓣形成和不形成OBL的眼睛的术前特征（年龄，性别，角膜曲率值，球面当量和中央角膜厚度）和术中手术因素（使用的能量，对接类型和皮瓣厚度）创建。分析了特定类型的OBL的可能风险因素。结果71例患者的135只眼接受了LASIK手术，其中98只眼发生了OBL（72.59％）。在单变量分析中，大于80 µm的皮瓣组与小于80 µm的皮瓣组相比，OBL发生率较低（P = .0424，比值比[OR] = 0.481）和硬对接与OBL形成增加有关（P = .0001，OR = 6.859）。在多变量分析中，硬对接是OBL发生的风险因素（P = .0003，OR = 6.329）。在亚组分析中，硬对接在80 µm皮瓣组中对OBL的发生有轻微影响（P = .086，OR = 3.564），但在大于80 µm皮瓣组中，有强烈的影响（P = .0018，或= 10.210）。结论硬对接是OBL发展的风险因素。但是，在LASIK手术中，硬对接对80 µm皮瓣组中OBL的影响很小。OBL的形成不影响视觉性能。[J Refract Surg。2019; 35（9）：583-589。]。硬对接是OBL发展的风险因素（P = .0003，OR = 6.329）。在亚组分析中，硬对接在80 µm皮瓣组中对OBL的发生有轻微影响（P = .086，OR = 3.564），但在大于80 µm皮瓣组中，有强烈的影响（P = .0018，或= 10.210）。结论硬对接是OBL发展的风险因素。但是，在LASIK手术中，硬对接对80 µm皮瓣组中OBL的影响很小。OBL的形成不影响视觉性能。[J Refract Surg。2019; 35（9）：583-589。]。硬对接是OBL发展的风险因素（P = .0003，OR = 6.329）。在亚组分析中，硬对接在80 µm皮瓣组中对OBL的发生有轻微影响（P = .086，OR = 3.564），但在大于80 µm皮瓣组中，有强烈的影响（P = .0018，或= 10.210）。结论硬对接是OBL发展的风险因素。但是，在LASIK手术中，硬对接对80 µm皮瓣组中OBL的影响很小。OBL的形成不影响视觉性能。[J Refract Surg。2019; 35（9）：583-589。]。但是，在LASIK手术中，硬对接对80 µm皮瓣组中OBL的影响很小。OBL的形成不影响视觉性能。[J Refract Surg。2019; 35（9）：583-589。]。但是，在LASIK手术中，硬对接对80 µm皮瓣组中OBL的影响很小。OBL的形成不影响视觉性能。[J Refract Surg。2019; 35（9）：583-589。]。