Immediate transepithelial photorefractive keratectomy for treatment of laser in situ keratomileusis flap complications.
OBJECTIVE
To study the role of photorefractive keratectomy (PRK) in the management of laser in situ keratomileusis (LASIK) flap complications.


METHODS
A retrospective analysis was performed of seven patients (14 eyes) who had bilateral, simultaneous LASIK (single surgeon [TGA], Summit Apex Plus laser, Hansatome microkeratome in six patients [12 eyes], Automated Corneal Shaper keratome in one patient [two eyes]). One eye of each patient received PRK for a flap complication. The seven patients (four women, three men) had a mean age of 39.2 years (range, 22 to 64 yr). The uncomplicated LASIK eyes had moderate to high myopia (-2.25 to -8.75 D) and the eyes with LASIK flap complications had mild to moderate myopia (-1.50 to -5.75 D). Immediate transepithelial PRK was performed in all eyes after repositioning the defective flap.


RESULTS
All seven patients had excellent visual outcome at 6 months follow-up; one patient required an enhancement (astigmatic keratotomy). Six of the seven LASIK eyes had best spectacle-corrected visual acuity of 20/20 or better and one LASIK eye had 20/25. In the transepithelial PRK eyes, six of the seven eyes had best spectacle-corrected visual acuity of 20/20 or better and one eye had 20/30.


CONCLUSIONS
Immediate transepithelial PRK treatment of irregular and incomplete LASIK flaps at the time of surgery is an excellent therapeutic option to delayed surgical treatment.
Jain
Vivek K
VK
Richmond Veterans Affairs Medical Center, Virginia Commonwealth University, USA.
Abell
Thomas G
TG
Bond
William I
WI
Stevens
Garth
G
D000328:Adult; D019573:Epithelium, Corneal / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D018903:Photorefractive Keratectomy / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000009:adverse effects*; D016896:Treatment Outcome; D014792:Visual Acuity