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Intraoperative and early postoperative flap-related complications of laser in situ keratomileusis using two types of Moria microkeratomes

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Abstract

The purpose of this study is to describe the incidence, management, and visual outcomes of intraoperative and early postoperative flap-related complications of laser in situ keratomileusis (LASIK) surgery using two types of Moria M2 microkeratomes. This retrospective analysis was performed on 806 primary LASIK cases. The intraoperative and early postoperative flap-related complications were identified and categorized according to type of Moria microkeratome. There were 52 intraoperative and early postoperative complications—one case of partial flap (0.124 %), one case of free flap (0.124 %), one case of small flap (0.124 %), 13 cases of epithelial defect (1.61 %), 12 cases of flap striae (1.49 %), 10 cases of diffuse lamellar keratitis (1.24 %), 10 cases of interface debris (1.24 %), three cases of epithelial ingrowth (0.37 %), and one case of microbial infection (0.124 %). The overall incidence of flap complications was 6.45 %. There were 27 right eye (6.73 %) and 25 left eye (6.17 %) complications. The incidence of complications with the Moria automated metallic head 130 microkeratome was 4.22 % and with the Moria single-use head 90 microkeratome was 2.23 %. We observed one culture-negative interface abscess which was cured with surgical cleaning and intensive medical treatment. The most common complication encountered was epithelial defects, followed by flap striae. Our study showed that LASIK with a microkeratome has a relatively low incidence of intraoperative and early postoperative flap complications. The authors have no financial interest in any of the issues contained in this article and have no proprietary interest in the development of marketing of or materials used in this study.

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References

  1. Pallikaris IG, Papatzanaki ME, Stathi EZ, Frenschock O, Georgiadis A (1990) Laser in situ keratomileusis. Lasers Surg Med 10:463–468

    Article  CAS  PubMed  Google Scholar 

  2. Duffey RJ, Leaming D (2003) US trends in refractive surgery: 2002 ISRS Survey. J Refract Surg 19:357–363

    PubMed  Google Scholar 

  3. Duffey RJ, Leaming D (2005) US trends in refractive surgery: 2003 ISRS/AAO survey. J Refract Surg 21:87–91

    PubMed  Google Scholar 

  4. Solomon KD, Fernández de Castro LE, Sandoval HP et al (2009) LASIK world literature review: quality of life and patient satisfaction. Ophthalmology 116(4):691–701

    Article  PubMed  Google Scholar 

  5. Bromley JG, Albright TD, Kharod-Dholakia B, Kim JK (2012) Intraoperative and postoperative complications of laser in situ keratomileusis. Expert Rev Opthalmol 7(1):25–31

    Article  Google Scholar 

  6. Gimbel HV, Basti S, Kaye GB, Ferensowicz M (1996) Experience during the learning curve of laser in situ keratomileusis. J Cataract Refact Surg 22:542–550

    Article  CAS  Google Scholar 

  7. Gimbel HV, Anderson Penno EE, van Westenbrugge JA et al (1998) Incidence and management of intraoperative and early postoperative complications in 1000 consecutive laser in situ keratomileusis cases. Ophthalmology 105:1847–1848

    Article  Google Scholar 

  8. Lin RT, Maloney RK (1999) Flap complications associated with lamellar refractive surgery. Am J Ophthalmol 127:129–136

    Article  CAS  PubMed  Google Scholar 

  9. Stulting RD, Carr JD, Thompson KP et al (1999) Complications of laser in situ keratomileusis for the correction of myopia. Ophthalmology 106:13–20

    Article  CAS  PubMed  Google Scholar 

  10. Tham VM, Maloney RK (2000) Microkeratome complications of laser in keratomileusis. Ophthalmology 107:920–924

    Article  CAS  PubMed  Google Scholar 

  11. Holland SP, Srivannaboon S, Reinstein DZ (2000) Avoiding serious corneal complications of laser assisted in situ keratomileusis and photorefractive keratectomy. Ophthalmology 107:640–652

    Article  CAS  PubMed  Google Scholar 

  12. Melki SA, Azar DT (2001) LASIK complications: etiology, management and prevention. Surv Ophthalmol 46:95–116

    Article  CAS  PubMed  Google Scholar 

  13. Jacobs JM, Taravella MJ (2002) Incidence of intraoperative flap complications in laser in situ keratomileusis. J Cataract Refract Surg 28:23–28

    Article  PubMed  Google Scholar 

  14. Yıldırım R, Devraoğlu K, Ozdamar A, Aras C, Ozkırıs A, Ozkan S (2001) Flap complications in our learning curve of laser in situ keratomileusis using the Hansatome microkeratome. Eur J Opthalmol 11(4):328–332

    Google Scholar 

  15. Sridhar MS, Rao SK, Vajpayee RB, Aasuri MK, Sinha HR (2002) Complications of laser in situ keratomileusis. Indian J Opthalmol 50(4):265–282

    Google Scholar 

  16. Walker MB, Wilson SE (2000) Lower intraoperative flap complications rate with the Hansatome microkeratome compared to the Automated Corneal Shaper. J Refract Surg 16:79–82

    CAS  PubMed  Google Scholar 

  17. Pallikaris IG, Katsanevaki VJ, Panagopoulou SI (2002) Laser in situ keratomileusis intraoperative complications using one type of microkeratome. Ophthalmology 109:57–63

    Article  PubMed  Google Scholar 

  18. Nakano K, Nakano E, Olivera M, Portellinha W, Alvarenga L (2004) Intraoperative microkeratome complications in 47,094 laser in situ keratomileusis surgeries. J Refract Surg 20:723–726

    Google Scholar 

  19. Carrillo C, Chayet AS, Dougherty PJ, Montes M, Magallanes R et al (2005) Incidence of complications during flap creation in LASIK using the NIDEK MK-2000 microkeratome in 26,600 cases. J Refract Surg 21:655–657

    Google Scholar 

  20. Khachikian SS, Moruson RT, Belin MW, Mishra G (2006) Thin head a single use microkeratome reduce epithelial defects during LASIK. J Refract Surg 22(5):482–485

    PubMed  Google Scholar 

  21. Al-Mezaine HS, Al-Amro SA, Al-Obeidan S (2011) Intraoperative flap complications in laser in situ keratomileusis with two types of microkeratomes. Saudi J Opthalmol 25:239–243

    Article  Google Scholar 

  22. Albelda-Vallés C, Martín-Reyes C, Ramos F, Beltran J, Llovet F, Baviera J (2007) Effect of preoperative keratometric power on intraoperative complications in LASIK in 34,099 eyes. J Refract Surg 23:592–597

    PubMed  Google Scholar 

  23. Randleman JB, Lynn MJ, Banning CS, Stulting RD (2007) Risk factors for epithelial defect formation during laser in situ keratomileusis. J Cataract Refract Surg 33:1738–1743

    Article  PubMed  Google Scholar 

  24. Chen YT, Tseng SH, Ma MC, Huang FC, Tsai YY (2007) Corneal epithelial damage during LASIK: a review of eyes 1873. J Refract Surg 23(9):916–923

    PubMed  Google Scholar 

  25. Shah MN, Misra M, Wihelmus KR, Koch DD (2006) Diffuse lamellar keratitis associated with epithelial defects after laser in situ keratomileusis. J Cataract Refract Surg 26:1312–1318

    Article  Google Scholar 

  26. Walker MB, Wilson SE (2000) Incidence and prevention of epithelial ingrowth within the interface after laser in situ keratomileusis. Cornea 19:170–173

    Article  CAS  PubMed  Google Scholar 

  27. Smith RJ, Maloney RK (1998) Diffuse lamellar keratitis: a new syndrome in lamellar refractive surgery. Opthalmology 105:1721–1726

    Article  CAS  Google Scholar 

  28. Perez-Santonja JJ, Sakla HF, Abad JL, Zorraquino A, Esteban J, Alio JL (1997) Nocardial keratitis after laser in situ keratomileusis. J Refract Surg 13:314–317

    CAS  PubMed  Google Scholar 

  29. Chang MA, Jain S, Azar DT (2004) Infections following laser in situ keratomileusis: an integration of the published literature. Surv Opthalmol 49(3):269–280

    Article  Google Scholar 

  30. Solomon R, Donnenfeld ED, Azar DT et al (2003) Infectious keratitis after laser in situ keratomileusis: results of an ASCRS survey. J Cataract Refract Surg 29:2001–2006

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, Medipol Mega Universite Hastanesi, Goz Hastaliklari, Istanbul Medipol University, TEM Otoyolu No: 1, Bagcilar, 34214, Istanbul, Turkey

    Yunus Karabela, Orkun Muftuoglu, Ibrahim Gokhan Gulkilik, Mehmet Selim Kocabora & Mustafa Ozsutcu

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  1. Yunus Karabela
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  2. Orkun Muftuoglu
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  3. Ibrahim Gokhan Gulkilik
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  4. Mehmet Selim Kocabora
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  5. Mustafa Ozsutcu
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Correspondence to Yunus Karabela.

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Karabela, Y., Muftuoglu, O., Gulkilik, I.G. et al. Intraoperative and early postoperative flap-related complications of laser in situ keratomileusis using two types of Moria microkeratomes. Int Ophthalmol 34, 1107–1114 (2014). https://doi.org/10.1007/s10792-014-9919-7

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  • DOI: https://doi.org/10.1007/s10792-014-9919-7

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