Traumatic Flap Complications After Femtosecond LASIK

Leccisotti, Antonio; Fields, Stefania V.; Bartolo, Giuseppe De; Malandrini, Alessandro

doi:10.1097/ico.0000000000002782

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…Being a rare event, our sample is too small to compare its occurrence in the 2 groups. Late flap dislocation is instead usually traumatic, and often caused by a tangential trauma [14]; an angled flap edge may theoretically provide a more solid cicatricial adhesion and less susceptibility to tangential traumas.…”

Section: Discussionmentioning

confidence: 99%

Creation of the Corneal Flap for Laser In Situ Keratomileusis with a 3-Dimension Femtosecond Laser Cut: Clinical and Optical Coherence Tomography Features

Leccisotti,

Fields,

De Bartolo

et al. 2024

Preprint

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Laser in situ keratomileusis (LASIK) is the gold standard in the surgical correction of refractive errors on the cornea. It entails the creation of a superficial hinged corneal flap by a femtosecond laser, ablation of the underlying stromal bed by an excimer laser, and reposition of the flap. The corneal flap can be build in a 2-dimension (2D) fashion with tapered edges, or in a 3-dimension (3D) fashion, with angled sidecut. The latter reduces the risk of flap dislocation and infiltration of epithelial cells. This retrospective study compares with optical coherence tomography 3D and 2D flaps, and respective intra- and early post-operative complications. Four hundred consecutive eyes were included, 200 for each group. In the 3D group, the mean edge angle was 92°. The procedure was in average 5.2 seconds slower in the 3D group (p=0). Non visually significant flap folds were found in 13 eyes of the 2D group and in 7 eyes of the 3D group (p= 0.17). An intracorneal opaque bubble layer induced by laser photodisruption was more commonly observed in the 3D group (9 eyes vs. 2; p=0.03). In conclusion, the creation of a LASIK flap by a 3D-femtosecond laser cut was safe and effective.

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Section: Discussionmentioning

confidence: 99%

Creation of the Corneal Flap for Laser In Situ Keratomileusis with a 3-Dimension Femtosecond Laser Cut: Clinical and Optical Coherence Tomography Features

Leccisotti,

Fields,

De Bartolo

et al. 2024

Preprint

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show abstract

“…Our sample is too small to compare its occurrence in the two groups, due to the rare occurrence of early flap dislocation. Late flap dislocation is usually traumatic and often caused by a tangential trauma [23]; an angled flap edge may theoretically provide more solid cicatricial adhesion and less susceptibility to tangential traumas.…”

Section: Discussionmentioning

confidence: 99%

Creation of a Corneal Flap for Laser In Situ Keratomileusis Using a Three-Dimensional Femtosecond Laser Cut: Clinical and Optical Coherence Tomography Features

Leccisotti,

Fields,

De Bartolo

et al. 2024

Optics

Self Cite

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Laser in situ keratomileusis (LASIK) is the most frequently used technique for the surgical correction of refractive errors on the cornea. It entails the creation of a superficial hinged corneal flap using a femtosecond laser, ablation of the underlying stromal bed using an excimer laser, and repositioning of the flap. A corneal flap with an angled side cut reduces the risk of flap dislocation and infiltration of epithelial cells and confers unique biomechanical properties to the cornea. A new laser software creating three-dimensional (3D) flaps using a custom angle side cut was retrospectively evaluated, comparing optical coherence tomography 3D (with intended 90° side cut) and 2D flaps (with tapered side cuts) as well as respective intra- and early postoperative complications. Four hundred consecutive eyes were included, two hundred for each group. In the 3D group, the mean edge angle was 92°, and the procedure was on average 5.2 s slower (p = 0). Non-visually significant flap folds were found in thirteen eyes of the 2D group and in seven eyes of the 3D group (p = 0.17). In conclusion, the creation of a LASIK flap using a 3D femtosecond laser cut, although slightly slower, was safe and effective. The side cut angle was predictable and accurate.

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“…It is noteworthy that despite an intended planar configuration, the LASIK flaps created by the Ziemer platform may in fact have a meniscus shape with a thinner center. 14 In addition, the final flap thickness is determined by various factors, including the density of the fluid used before applanation and the single device used. In a large Ziemer series, for a programmed 110-μm flap, the final mean central thickness reached 117.3 μm, with a SD of 8.3 μm.…”

Section: Discussionmentioning

confidence: 99%

Femtosecond LASIK Retreatments After Primary Myopic Photorefractive Keratectomy

Leccisotti

Fields²,

Bartolo³

2022

Cornea

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The purpose of the study was to evaluate the results and complications of laser-assisted in situ keratomileusis (LASIK) using a femtosecond laser as a retreatment modality of myopia and myopic astigmatism after previous myopic photorefractive keratectomy (PRK).Methods: In this retrospective, consecutive, noncomparative case series study, 69 eyes of 41 patients receiving femtosecond LASIK after previous myopic PRK were evaluated. The mean age was 43.0 6 8.9 years. The preoperative mean SE was 21.82 6 1.01 diopter (D), range 20.62 to 26.25. The mean central epithelial thickness was 65 6 5 mm. A flap was created using a low-energy femtosecond laser (Ziemer LDV Z8), with a programmed thickness calculated by adding 40 mm to the epithelial thickness. Refractive ablation was performed using a Technolas Teneo 317 laser (Bausch and Lomb).Results: Twelve months after LASIK, the mean SE was 20.03 6 0.17 D, with all eyes #0.50 D of SE. The mean DE was 0.30 6 0.25, with 62 eyes (89.9%) #0.50 D and all eyes #1 D. The mean corrected distance visual acuity (CDVA) was 0.04 6 0.10 logMAR; no eye lost more than 1 line of CDVA. The mean uncorrected distance visual acuity was 0.07 6 0.13 logMAR, being 20/25 or better in all eyes. The safety index (postoperative CDVA/preoperative CDVA) was 1.05. The efficacy index (postoperative uncorrected distance visual acuity/ preoperative CDVA) was 0.98. No significant complications occurred.Conclusions: Myopic retreatments by femtosecond LASIK after primary PRK yielded excellent refractive results without relevant complications. The flap thickness must be tailored to the epithelial thickening after PRK.

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Traumatic Flap Complications After Femtosecond LASIK

Cited by 7 publications

References 16 publications

Creation of the Corneal Flap for Laser In Situ Keratomileusis with a 3-Dimension Femtosecond Laser Cut: Clinical and Optical Coherence Tomography Features

Creation of the Corneal Flap for Laser In Situ Keratomileusis with a 3-Dimension Femtosecond Laser Cut: Clinical and Optical Coherence Tomography Features

Creation of a Corneal Flap for Laser In Situ Keratomileusis Using a Three-Dimensional Femtosecond Laser Cut: Clinical and Optical Coherence Tomography Features

Femtosecond LASIK Retreatments After Primary Myopic Photorefractive Keratectomy

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