title: Photorefractive keratectomy for treatment of flap complications in laser in situ keratomileusis.
abstract: OBJECTIVE
  To present the results of photorefractive keratectomy (PRK) for treatment of laser in situ keratomileusis (LASIK) flap complications.
  
  
  METHODS
  Compilation of case reports through solicitation on Kera-net, an Internet surgery discussion site.
  
  
  RESULTS
  PRK was performed on 13 patients from 2 weeks to 6 months after LASIK flap complications. The technique used for the PRK varied. Epithelial removal was performed using no-touch phototherapeutic keratectomy (PTK) in six of the 13 patients and manual debridement in the other seven patients. A dilute solution of 20% ethanol was used to facilitate manual debridement in five of the seven patients. In two of these five patients, the epithelium was replaced as in laser-assisted subepithelial keratomileusis (LASEK). A solution of 0.02% mitomycin C was used after laser ablation to prevent haze formation in three patients. After an average 7 months of follow-up, uncorrected visual acuity was 20/20 in six patients, 20/25 in four patients, and 20/30 in two patients. The visual acuity in one patient was 20/80, purposely left undercorrected for monovision. Best spectacle-corrected visual acuity was 20/20 in 10 of 13 patients. Three patients were 20/25, losing one line of best spectacle-corrected visual acuity. On slit-lamp examination, at last follow-up appointment, stromal haze was graded from trace to none in all patients.
  
  
  CONCLUSIONS
  Photorefractive keratectomy is a safe and effective technique for treatment of patients with LASIK flap complications.
authors.affiliation: Department of Ophthalmology, Upstate Medical Center, Syracuse, New York, USA. weisenr@aol.com
authors.forename: Robert W
authors.initials: RW
authors.lastname: Weisenthal
authors.forename: James
authors.initials: J
authors.lastname: Salz
authors.forename: Alan
authors.initials: A
authors.lastname: Sugar
authors.forename: Alan
authors.initials: A
authors.lastname: Mandelberg
authors.forename: Michael
authors.initials: M
authors.lastname: Furlong
authors.forename: Steven
authors.initials: S
authors.lastname: Bagan
authors.forename: Sergio
authors.initials: S
authors.lastname: Kandleman
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D018903:Photorefractive Keratectomy; D012086:Reoperation; D013524:Surgical Flaps / Q000009:adverse effects*; D016896:Treatment Outcome; D014792:Visual Acuity