title: Photorefractive keratectomy with mitomycin C for the management of a LASIK flap complication following a penetrating keratoplasty.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of photorefractive keratectomy (PRK) with mitomycin C (MMC) following a buttonhole secondary to attempted laser in situ keratomileusis (LASIK) in an eye that had undergone a prior penetrating keratoplasty (PKP).
  
  
  METHODS
  Case report and review of the literature. A 26-year-old man underwent PRK with MMC following a buttonhole flap complication after LASIK in an eye that had undergone a PKP for keratoconus.
  
  
  RESULTS
  Three months following the procedure, the patient demonstrated a clear cornea and a best-corrected visual acuity of 20/20.
  
  
  CONCLUSIONS
  To our knowledge, this is the first case report of buttonhole during LASIK following a PKP and the use of PRK to treat a LASIK flap complication following a successful PKP. In addition, this is the first case report of prophylactic use of MMC to prevent corneal haze with PRK following PKP. A buttonhole is a rare complication following LASIK for residual refractive error following PKP, which can be successfully managed with PRK and prophylactic MMC.
authors.affiliation: Ophthalmic Consultants of Long Island, Rockville Centre, New York 11570, USA.
authors.forename: Renée
authors.initials: R
authors.lastname: Solomon
authors.forename: Eric D
authors.initials: ED
authors.lastname: Donnenfeld
authors.forename: Henry D
authors.initials: HD
authors.lastname: Perry
mesh_terms: D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D015948:Keratoplasty, Penetrating; D054018:Lasers, Excimer; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use*; D018903:Photorefractive Keratectomy / Q000379:methods*; D011183:Postoperative Complications / Q000188:drug therapy*; D013524:Surgical Flaps
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin