[Circular flap rhexis: a refinement technique for LASIK re-treatment].
OBJECTIVE
To describe a new approach to re-treatment after Laser in situ keratomileusis (LASIK) by means of lifting the corneal flap in order to decrease the epithelial damage and its related complications, such as epithelial ingrowth and flap melting, which are more frequent after LASIK re-treatment than after primary LASIK.


METHODS
The new technique, called circular flap rhexis, is based on a careful flap edge identification, linear epithelial tear for minimizing epithelial irregularities and defects, and a delicate flap replacement to promote a strong adhesion between the flap edge and the stromal bed. The LASIK re-treatment with this flap rhexis technique was performed in 43 eyes at 3 or 6 months after the primary LASIK. After a 12 month follow-up, the epithelial ingrowth and flap melting rates were recorded.


RESULTS
Epithelial growth was found in 9.3% of the cases (4 out of 43 eyes) and flap melting in 2.3% of the cases (1 out of 43) at 12 months after LASIK re-treatment by circular flap rhexis. These disorders were always peripheral and did not affect visual acuity or corneal astigmatism.


CONCLUSIONS
LASIK re-treatment using circular flap rhexis is an effective technique to decrease the epithelium related complications after LASIK re-treatment.
Pérez-Santonja
J J
JJ
Unidad de Cirugía Refractiva y Córnea, Instituto Oftalmológico de Alicante, Facultad de Medicina, Universidad Miguel Hernández, Alicante, España.
Medrano
M
M
Ruiz-Moreno
J M
JM
Cardona-Ausina
C
C
Alió
J L
JL
D019573:Epithelium, Corneal / Q000601:surgery* / Q000648:ultrastructure; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D012008:Recurrence; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing