Abstract
Using the femtosecond laser to create the corneal flap during laser in situ keratomileusis (LASIK) has many advantages in predictability and reliability over the microkeratome. However, each surgical procedure may have complications. One of them is vertical gas breakthrough as a result of escaping gas bubbles from the dissection plane into the subepithelial space. In this case, the cause would be related to a previous thin flap or a focal break in the Bowman’s layer. The refractive surgeon should be aware that this complication can be associated with epithelial down growth, corneal scar, and microstriae. A decrease of best corrected visual acuity (BCVA) may occur if the pupillary area is involved.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Durrie DS, Kezirian GM (2005) Femtosecond laser versus mechanical keratome flaps in wavefront-guided laser in situ keratomileusis; prospective contralateral eye study. J Cataract Refract Surg 31(1):120–126
Kezirian GM, Stonecipher KG (2004) Comparison of the IntraLase femtosecond laser and mechanical keratomes for laser in situ keratomileusis. J Cataract Refract Surg 30:804–811
Srinivasan S, Herzig S (2007) Sub-epithelial gas breakthrough during femtosecond laser flap creation for LASIK. Br J Ophthalmol 91:1373
Seider MI (2008) Epithelial breakthrough during IntraLase flap creation for laser in situ keratomileusis. J Cataract Refract Surg 34:859–863
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Electronic Supplementary Material
Below is the link to the electronic supplementary material.
A vertical bubble between the previous flap and the epithelium was clearly visible at the superior margin of the flap. The flap was gently lifted without creating a buttonhole. At the end, the standard excimer ablation procedure was performed (MP4 5937 kb)
Rights and permissions
Copyright information
© 2015 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Alió, J.L., Wróbel, D., Abbouda, A. (2015). Vertical Gas Breakthrough During Femtosecond Laser Flap Creation for Laser In Situ Keratomileusis in an Eye with Previous Microkeratome Flap. In: Alió, J., Azar, D., Abbouda, A., Aswad, A. (eds) Difficult and Complicated Cases in Refractive Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55238-0_24
Download citation
DOI: https://doi.org/10.1007/978-3-642-55238-0_24
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-55237-3
Online ISBN: 978-3-642-55238-0
eBook Packages: MedicineMedicine (R0)