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Published on: June 12, 2012
Intraoperative flap complications in laser in situ keratomileusis with two types of microkeratomes
Hani S Al-Mezaine1, Saleh A Al-Amro, Saleh Al-Obeidan
1Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Purpose:
To determine the incidence and types of intraoperative flap complications in laser in situ keratomileusis (LASIK) encountered with the Hansatome microkeratome and the Moria microkeratome.
Methods:
In this retrospective case series, all patients with intraoperative flap complications who were treated between June 1999 and July 2008 at the Eye Consultants Center in Riyadh, Saudi Arabia, were identified and reviewed.
Results:
Of the 4352 subjects who underwent bilateral primary LASIK procedure, intraoperative microkeratome complications were detected in 89 eyes of 83 patients. The overall incidence of flap complications was 89/8704 (1.00%): incomplete flaps occurred in 53 eyes (0.60%), followed by buttonhole flaps in 17 eyes (0.19%), free complete flaps in 10 eyes (0.11%), free partial flaps in 6 eyes (0.07%), sluffed epithelium in 2 eyes (0.023%), and a splitted flap (vertical flap cut) in 1 eye (0.01%). The incidence rates of intraoperative flap complications with the Hansatome microkeratome and the Moria microkeratome were 1.21% (41/3378) and 0.90% (48/5326), respectively (P = 0.19). There was a statistically significant difference between the two microkeratomes with regard to the incidence of buttonhole flaps: 0.33% (11/3378) for the Hansatome microkeratome versus 0.11% (6/5326) for the Moria microkeratome (P = 0.04).
Conclusion:
Generally, the incidence rates of intraoperative flap complications with the Hansatome microkeratome and the Moria microkeratome were similar. However, buttonhole flaps occurred more often with the Hansatome microkeratome (a type of microkeratome that produces larger flaps). The commonest complication encountered was the incomplete flap, followed by the buttonhole flap and free flap.
Insights
Laser in situ keratomileusis (LASIK) flap complications occurred in 1.00% of eyes. While overall complication rates were similar between Hansatome and Moria microkeratomes, Hansatome had a higher incidence of buttonhole flaps.
Area of Science:
- Ophthalmology
- Surgical Technology
- Corneal Surgery
Background:
- Intraoperative flap complications can affect visual outcomes after laser in situ keratomileusis (LASIK).
- Comparing microkeratome devices is crucial for understanding complication rates.
Purpose of the Study:
- To determine the incidence and types of intraoperative flap complications during LASIK using Hansatome and Moria microkeratomes.
- To compare complication rates between the two microkeratome systems.
Main Methods:
- Retrospective case series of patients undergoing primary LASIK.
- Review of intraoperative flap complications between June 1999 and July 2008.
- Analysis of complication types and incidence rates for Hansatome and Moria microkeratomes.
Main Results:
- Overall incidence of flap complications was 1.00% (89/8704 eyes).
- Incomplete flaps (0.60%) were most common, followed by buttonhole (0.19%) and free flaps (0.11%).
- Hansatome (1.21%) and Moria (0.90%) showed similar overall complication rates (P=0.19), but Hansatome had significantly more buttonhole flaps (0.33% vs 0.11%, P=0.04).
Conclusions:
- Overall intraoperative flap complication rates with Hansatome and Moria microkeratomes are similar.
- Hansatome microkeratome was associated with a higher incidence of buttonhole flaps.
- Incomplete flaps represent the most frequent complication in LASIK procedures.
