Confocal microscopic imaging of reticular folds in a laser in situ keratomileusis flap.
OBJECTIVE
To report the clinical and confocal microscopic characteristics of reticular folds (mudcracks) in a cornea after laser in situ keratomileusis (LASIK).


METHODS
A 30-year-old male showed reticular flap folds on slit-lamp examination 1 week after LASIK. In addition to slit-lamp biomicroscopy, confocal in vivo microscopy was performed.


RESULTS
Examination with a confocal white-light slit-scanning microscope revealed distinct folds of Bowman's layer and underlying microfolds throughout the flap stroma. After flap re-lifting, no changes could be determined, either clinically or by confocal microscopy. At 12 months following the procedure, best spectacle-corrected visual acuity was slightly improved, but the folds, as imaged by confocal microscopy, still persisted.


CONCLUSIONS
In the present case, reticular folds after LASIK involved the entire thickness of the flap. Simple flap lifting was not sufficient for smoothing out the folds.
Kohnen
T
T
Department of Ophthalmology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany. kohnen@em.uni-frankfurt.de
Bühren
J
J
Baumeister
M
M
D000328:Adult; D003316:Corneal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D003319:Corneal Stroma / Q000473:pathology*; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D018613:Microscopy, Confocal; D009216:Myopia / Q000601:surgery; D012086:Reoperation; D013524:Surgical Flaps / Q000473:pathology*; D014792:Visual Acuity