Flap Loss in More Than 1 Million LASIK Procedures: Incidence, Management, and Visual Outcomes

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Surgery

Background:

• Laser in situ keratomileusis (LASIK) is a common refractive surgery procedure.
• Complications, though rare, require careful analysis and management strategies.

Purpose of the Study:

• To determine the incidence of flap loss during LASIK procedures.
• To evaluate management techniques for LASIK flap loss.
• To assess the visual outcomes following LASIK flap loss.

Main Methods:

• A retrospective case series involving patients who experienced LASIK flap loss across multiple centers and surgeons.
• Utilized Moria microkeratomes for flap creation.
• Assessed visual acuity (UDVA, CDVA), predictability, safety, and efficacy, comparing with a control group.

Main Results:

• Flap loss occurred in 16 of 1,008,849 eyes.
• Patients managed with topical mitomycin C (MMC) and bandage contact lenses showed outcomes.
• While uncorrected distance visual acuity (UDVA) was worse, corrected distance visual acuity (CDVA) differences were not significant.

Conclusions:

• LASIK flap loss is an extremely rare complication.
• Management with MMC and bandage contact lenses can lead to acceptable safety and visual results.
• Further research may refine optimal management protocols.