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Microkeratome complications

Jimmy K Lee1, Esi W Nkyekyer, Roy S Chuck

  • 1Yale Eye Center, New Haven, Connecticut 06510, USA. jimmy.k.lee@yale.edu

Current Opinion in Ophthalmology
|April 29, 2009
PubMed
Abstract

Insights

Complications during laser in-situ keratomileusis (LASIK) flap creation are rare. While mechanical microkeratomes have associated risks like irregular flaps, femtosecond lasers offer greater flap stability without impacting final visual outcomes.

Area of Science:

  • Ophthalmology
  • Surgical Technology
  • Corneal Surgery

Background:

  • Laser in-situ keratomileusis (LASIK) is a common refractive surgery.
  • Corneal flap creation is a critical step in LASIK surgery.
  • Microkeratomes, both mechanical and femtosecond laser-based, are used for flap creation.

Purpose of the Study:

  • To review and discuss complications associated with microkeratome flaps in LASIK surgery.
  • To compare the complication profiles of mechanical microkeratomes versus femtosecond lasers for LASIK flap creation.
  • To identify risk factors for microkeratome flap complications.

Main Methods:

  • Literature review of studies on LASIK microkeratome flaps.
  • Analysis of reported complications such as partial/irregular flaps, buttonholes, and free flaps.
  • Comparison of flap characteristics and stability between mechanical and femtosecond laser platforms.

Main Results:

  • Common complications include partial or irregular flaps, buttonholes, and free flaps.
  • Risk factors identified include older age, hyperopia, and prolonged contact lens wear.
  • Femtosecond lasers demonstrate superior flap stability and dimensional consistency over mechanical microkeratomes, with no significant difference in final visual acuity.

Conclusions:

  • Mechanical microkeratomes are associated with specific flap complications in LASIK.
  • Femtosecond laser platforms offer enhanced flap stability and precision compared to mechanical microkeratomes.
  • Despite differences in flap characteristics, final visual outcomes are comparable between the two methods.

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