title: Complicated flap creation with femtosecond laser after radial keratotomy.
abstract: OBJECTIVE
  To report a case of laser in situ keratomileusis (LASIK) that used the Intralase femtosecond laser 14 years after radial keratotomy (RK) for residual myopic astigmatism.
  
  
  METHODS
  A 39 year-old male patient had undergone a bilateral RK operation for myopic correction. The manifest refraction was -1.25 -3.00 x 175 D, with uncorrected visual acuity (UCVA) of 20/50 and best-corrected visual acuity (BCVA) of 20/20. The central and thinnest pachymetry measurements were 582 and 576 mum, respectively, by Orbscan II.
  
  
  RESULTS
  Intralase was used for LASIK, and initially, a loss of suction was seen during flap formation. The flap could be created again at the same intracorneal plane. During flap lifting, the RK incisions were separated, and one of the RK incisions progressed to the corneal center with the force applied by the blunt spatula. No piece was separated completely from the flap. Excimer laser treatment and flap repositioning could be done without any problems. At the fifth postoperative month, his UCVA was 20/20. All RK incisions seemed well aligned. There was no haze or epithelial ingrowth.
  
  
  CONCLUSIONS
  This case showed that the Intralase femtosecond laser not only has no unique benefit as opposed to the mechanical keratome for post-RK eyes but also can lead to serious complications. We recommend that femtosecond laser flap formation not be used in post-RK eyes.
authors: Beyoglu Eye Research and Training Hospital, Istanbul, Turkey.
authors: Irfan
authors: I
authors: Perente
authors: Canan Asli
authors: CA
authors: Utine
authors: Hanefi
authors: H
authors: Cakir
authors: Omer Faruk
authors: OF
authors: Yilmaz
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000601:surgery*; D003319:Corneal Stroma / Q000601:surgery*; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation*; D007646:Keratotomy, Radial; D007834:Lasers; D008297:Male; D009216:Myopia / Q000601:surgery*; D012086:Reoperation; D013524:Surgical Flaps; D014792:Visual Acuity