Refractive outcomes of laser in situ keratomileusis after flap complications

Namrata Sharma, Deepta Ghate, Tushar Agarwal, Rasik B. Vajpayee

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: To study the refractive and visual outcomes, including surgically induced astigmatism, of laser in situ keratomileusis (LASIK) after flap buttonholes and incomplete flaps. Setting: Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. Methods: This was a retrospective case series of 15 patients (15 eyes) who had LASIK after flap complications (6 eyes with buttonholes and 9 with incomplete flaps). The second surgery was performed after the refraction was stable for 2 months. The refractive and visual outcomes were studied. Results: After the flap complication, the spheroequivalent did not change significantly (P = .78) but the mean pachymetry changed from 523.6 μm ± 23.14 (SD) to 530.4 ± 23.96 μm (P = .04) and the mean absolute cylinder changed from 0.63 ± 1.01 diopter (D) to 0.88 ± 0.87 D (P = .026). The second surgery was performed at a mean interval of 6.2 months (range 3 to 17 months). Two eyes had flap complications (irregular flaps) again after the second surgery. At the 6-month follow-up, the mean spheroequivalent was -0.34 ± 0.65 D and the mean cylinder was 0.15 ± 0.19 D × 83.6. Thirteen eyes (86.66%) were within 0.5 D of the attempted correction. Post-LASIK complications included diffuse lamellar keratitis (1 eye), epithelial ingrowth (1 eye), and flap striae (2 eyes). After the flap complication, no eye lost 2 or more lines of best spectacle-corrected visual acuity (BSCVA); but after the second surgery at 6 months, 1 eye had lost 2 lines of BSCVA. Six months postoperatively, all eyes had a BSCVA of 20/40 or better. Conclusion: Laser in situ keratomileusis after flap complications is associated with good refractive and visual outcomes; however, there is a higher risk for intraoperative and postoperative complications after the second surgery.

Original languageEnglish (US)
Pages (from-to)1334-1337
Number of pages4
JournalJournal of cataract and refractive surgery
Volume31
Issue number7
DOIs
StatePublished - Jul 2005

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Laser In Situ Keratomileusis
Visual Acuity
India
Astigmatism
Keratitis
Intraoperative Complications

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology
  • Sensory Systems

Cite this

Refractive outcomes of laser in situ keratomileusis after flap complications. / Sharma, Namrata; Ghate, Deepta; Agarwal, Tushar; Vajpayee, Rasik B.

In: Journal of cataract and refractive surgery, Vol. 31, No. 7, 07.2005, p. 1334-1337.

Research output: Contribution to journalArticle

Sharma, Namrata ; Ghate, Deepta ; Agarwal, Tushar ; Vajpayee, Rasik B. / Refractive outcomes of laser in situ keratomileusis after flap complications. In: Journal of cataract and refractive surgery. 2005 ; Vol. 31, No. 7. pp. 1334-1337.
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abstract = "Purpose: To study the refractive and visual outcomes, including surgically induced astigmatism, of laser in situ keratomileusis (LASIK) after flap buttonholes and incomplete flaps. Setting: Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. Methods: This was a retrospective case series of 15 patients (15 eyes) who had LASIK after flap complications (6 eyes with buttonholes and 9 with incomplete flaps). The second surgery was performed after the refraction was stable for 2 months. The refractive and visual outcomes were studied. Results: After the flap complication, the spheroequivalent did not change significantly (P = .78) but the mean pachymetry changed from 523.6 μm ± 23.14 (SD) to 530.4 ± 23.96 μm (P = .04) and the mean absolute cylinder changed from 0.63 ± 1.01 diopter (D) to 0.88 ± 0.87 D (P = .026). The second surgery was performed at a mean interval of 6.2 months (range 3 to 17 months). Two eyes had flap complications (irregular flaps) again after the second surgery. At the 6-month follow-up, the mean spheroequivalent was -0.34 ± 0.65 D and the mean cylinder was 0.15 ± 0.19 D × 83.6. Thirteen eyes (86.66{\%}) were within 0.5 D of the attempted correction. Post-LASIK complications included diffuse lamellar keratitis (1 eye), epithelial ingrowth (1 eye), and flap striae (2 eyes). After the flap complication, no eye lost 2 or more lines of best spectacle-corrected visual acuity (BSCVA); but after the second surgery at 6 months, 1 eye had lost 2 lines of BSCVA. Six months postoperatively, all eyes had a BSCVA of 20/40 or better. Conclusion: Laser in situ keratomileusis after flap complications is associated with good refractive and visual outcomes; however, there is a higher risk for intraoperative and postoperative complications after the second surgery.",
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