Mild myopic astigmatism corrected by accidental flap complication: a case report

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• Laser in-situ keratomileusis (LASIK) is a common refractive surgery procedure.
• Complications, though rare, can occur during LASIK, impacting surgical outcomes.
• Understanding flap-related complications is crucial for patient safety and surgical technique refinement.

Purpose of the Study:

• To report a unique case of an accidental LASIK flap complication.
• To analyze the consequences of microkeratome resistance during flap creation.
• To highlight an unexpected refractive outcome following a LASIK complication.

Main Methods:

• A 35-year-old female patient underwent LASIK for myopia and astigmatism.
• A microkeratome encountered resistance during flap creation, resulting in an abnormal flap.
• The flap was repositioned, LASIK was discontinued, and the cornea healed.
• Postoperative visual acuity and refractive error were assessed.

Main Results:

• An unusual epithelial flap with a central rectangle and bilateral mirror-image flaps was created due to microkeratome resistance.
• The cornea healed with minimal scarring, showing faint linear vertical scars.
• Postoperative examination revealed 20/20 uncorrected visual acuity (UCVA).
• The patient's manifest and cycloplegic refractions were plano, indicating complete correction of myopia and astigmatism.

Conclusions:

• Accidental LASIK flap complications can occur due to mechanical resistance during microkeratome use.
• Despite the complication, the patient achieved excellent uncorrected visual acuity and refractive correction.
• This case demonstrates an unusual instance where a surgical complication inadvertently corrected mild myopic astigmatism.