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Visual outcomes after femtosecond laser in situ keratomileusis flap complications
Dip S Jadav1, Niraj Desai1, Kenneth R Taylor1
1From the Department of Ophthalmology (Jadav, Desai), The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA; Department of Flight Medicine (Taylor), 14th Medical Group, Columbus AFB, Mississippi, USA; Department of Ophthalmology (Caldwell, Panday, Reilly), Wilford Hall Ambulatory Surgical Center, Lackland Air Force Base, San Antonio, Texas.
Purpose:
To compare visual outcomes in normal and complicated laser in situ keratomileusis (LASIK) flaps constructed with a femtosecond laser.
Setting:
Wilford Hall Ambulatory Surgical Center, San Antonio, Texas.
Design:
Retrospective chart review.
Methods:
The main outcome measures were uncorrected distance visual acuity (UDVA) and best-corrected distance visual acuity (CDVA) at 1 month post-surgery, which were compared in patients with and without complications during flap creation.
Results:
This retrospective chart review identified 586 eyes of 293 consecutive patients who had bilateral simultaneous femtosecond LASIK for myopia. A normal flap was attained in 539 (91.8%) of patients. At 1 month postoperatively, the mean UDVA was 20/19.1, and the CDVA was 20/16.8. 3 (0.51%) of patients experienced an incomplete side cut or intraoperative flap tear (the mean 1-month uncorrected distance visual acuity [UDVA] was 20/17.5 and the corrected distance visual acuity [CDVA] was 20/16.9 in both groups). Microstriae were seen in 28 (4.8%) of patients (mean 1-month UDVA, 20/21.7; CDVA, 20/17.4). Diffuse lamellar keratitis appeared in 4 (0.68%) of patients (mean 1-month UDVA, 20/21.7; CDVA, 20/15.6). Epithelial ingrowth developed in 9 (1.5%) of patients (mean 1-month UDVA, 20/18.7; CDVA, 20/16.9). There was no statistically significant difference in UDVA or CDVA at 1 month postoperatively between complicated and uncomplicated flaps (P > .05), and complicated flaps did not lose a statistically significant amount of CDVA or low-contrast acuity (CDVA 5%) compared to preoperative values.
Conclusions:
Intraoperative and postoperative complications of LASIK flaps created with the femtosecond laser were rare, and their visual outcomes were equivalent to those of normal flaps.
Financial Disclosure:
Charles D. Reilly is a consultant to Alcon Labs and Abbott Medical Optics at present, but was not at the time of the study. For the remaining authors none are declared.
