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Laser in situ keratomileusis buttonhole: classification and management algorithm.

Mona Harissi-Dagher1, Amit Todani, Samir A Melki

  • 1Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA.

Journal of Cataract and Refractive Surgery
|November 14, 2008
PubMed
Summary
This summary is machine-generated.

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Laser in situ keratomileusis (LASIK) flap buttonholes were classified and managed using a staged treatment algorithm. This approach led to good uncorrected and best spectacle-corrected visual acuity following surface ablation retreatment.

Area of Science:

  • Ophthalmology
  • Refractive Surgery
  • Corneal Surgery

Background:

  • Laser in situ keratomileusis (LASIK) is a common refractive surgery.
  • Intraoperative complications, such as flap buttonholes, can occur during LASIK.
  • Effective management strategies are crucial for optimal visual outcomes.

Purpose of the Study:

  • To classify and describe the management of LASIK flap buttonholes.
  • To report visual outcomes after treating LASIK flap buttonholes.
  • To evaluate a treatment algorithm for LASIK flap buttonholes.

Main Methods:

  • Retrospective observational case series of 15 patients with LASIK flap buttonholes.
  • Classification of buttonholes by stage.
  • Development and application of a stage-based treatment algorithm.

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  • Assessment of uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA).

    • Main Results:

    • All 9 retreated patients achieved postoperative UCVA of 20/25 or better.
    • No retreated patient experienced a loss of BSCVA.
    • Post-retreatment median UCVA improved to 20/20(-2) and median BSCVA to 20/20.
    • Complications included overcorrection (3 patients) and corneal haze (2 patients).

    Conclusions:

    • Classification of buttonholes aided in guiding treatment decisions.
    • A simple treatment algorithm based on surface ablation successfully restored good visual acuity.
    • Management of LASIK flap buttonholes can lead to favorable visual outcomes.