Photorefractive keratectomy for treatment of flap complications in laser in situ keratomileusis.
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.
Weisenthal
Robert W
RW
Department of Ophthalmology, Upstate Medical Center, Syracuse, New York, USA. weisenr@aol.com
Salz
James
J
Sugar
Alan
A
Mandelberg
Alan
A
Furlong
Michael
M
Bagan
Steven
S
Kandleman
Sergio
S
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