[Complications at the beginning of refractive surgery]

We revised the charts of first interventions of refractive surgery with LASIK and PRK in order to evaluate the results and to analyze the incidents and complications we encountered as beginners in photorefractive surgery. In total 50 eyes of 29 patients (7 men and 22 women) were operated. 42 eyes were myopic (21 with astigmatism) and 8 eyes were hyperopic (6 with astigmatism). LASIK was performed in 45 cases and PRK in 5 cases all myopias. The intervention was performed with AESCULAP MEDITEC MEL 70G-Scan laser. The follow-up period was between 3 and 12 months. Per total the results were as follows: Average pre-operative non-corrected visual acuity was 0.23 Average pre-operative corrected visual acuity was 0.8 Average post-operative non-corrected visual acuity was 0.74 Average post-operative corrected visual acuity was 0.77 We noted some minor intra-operative incidents: insufficient anesthesia (6%) and some important intra-operative incidents: free cap (6%), flap desepithelization (4%). Minor post-operative complications were: mild corneal edema, corneal desepitelisation (14%), and some severe post-operative complications: corneal ulcer (4%), comeal mycosis (2%), pupilary paresis (2%). Under-correction was present per total in 52% of cases, but mainly in myopias over 10 dpt (30%), as well as induced astigmatism (10%). Major complicated cases were only 5 (10%) and were consecutive to some mechanical problems (vacuum failure, system decentration). An interesting observation is related to IOP evolution. In average a decrease of IOP was noted from pre-operative medium of 14.43 mmHg to a post-operative medium value of 10.73 mmHg.