February 15, 2002

Surgeons Describe a 5-8% Flap Complication Rate for Lasik

Preventing LASIK Buttonholes
Steep corneas and surface dryness increase patient risk

Balamurali K. Ambati, MD, and Alan N. Carlson, MD

LASIK is now widely performed, with an estimated 1.5 million procedures performed last year.1 Flap complications have been reported in 5% to 8.7% of cases.2 The buttonhole, occurring at a rate of 0.3% to 2.6%, is one of the more serious flap abnormalities because it results in loss of BCVA.3-6

A buttonhole in the flap occurs when the microkeratome blade travels too superficially and breaches the central epithelial/Bowman's complex. A partial thickness buttonhole includes just the Bowman's layer; full thickness buttonholes occur when the blade exits anteriorly through the epithelium. A thin flap occurs when the keratome cuts within or anterior to Bowman's layer. This manifests with a shiny reflex on the stromal surface and can be recognized by a flap thickness of less than 60 Ám (as the corneal epithelium is approximately 50 Ám and Bowman's approximately 12 Ám).

The complete article is available at www.reviewofrefractivesurgery.com/index.asp?page=6_6.htm

Posted by Admin at February 15, 2002 12:33 PM