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

A 35-year-old female presented for laser in-situ keratomileusis (LASIK). Her preoperative eye exam was normal, with a preop refraction of OD -2.50 D Sph +1.25 D Cyl x175 and OS -2.75 D Sph +1.50 D Cyl x165 (cycloplegic and manifest), with 20/20 BCVA OU. The central pachymetry reading was 553 mum in the right eye. Preoperative topography was normal. At the start of the pendular microkeratome path, some resistance was felt, but the microkeratome continued along its path. Upon inspection of the flap, there was a central rectangle of intact epithelium with two mirror-image flaps on both sides. The flap was repositioned and LASIK was discontinued. The cornea healed with two faint thin linear vertical parallel scars at the edge of the pupil. Postoperative inspection of the blade revealed central blunting. One month postoperatively, the uncorrected visual acuity (UCVA) was 20/20. Manifest and cycloplegic refractions were plano. This is an interesting case of accidental flap complication resulting in the correction of mild myopic astigmatism.