Epithelial breakthrough during IntraLase flap creation for laser in situ keratomileusis.
We report the clinical manifestations and outcomes in 4 patients who experienced premature gas-bubble leakage during raster lamellar dissection during IntraLase femtosecond laser corneal flap creation. Three patients experienced a full-thickness epithelial breakthrough and the fourth, a flap tear. The patient who experienced the flap tear was unable to have laser in situ keratomileusis successfully. The flap complications did not result in a decreased best corrected visual acuity in any patient but may have resulted in epithelial ingrowth in one and a corneal scar and microstriae in another. Potential predisposing factors for epithelial breakthrough, the incidence of epithelial breakthrough, and methods for avoiding and salvaging traumatic corneal flaps are discussed.
Seider
Michael I
MI
Bascom Palmer Eye Institute, Miami, Florida 33136, USA.
Ide
Takeshi
T
Kymionis
George D
GD
Culbertson
William W
WW
O'Brien
Terrence P
TP
Yoo
Sonia H
SH
D000328:Adult; D003319:Corneal Stroma / Q000601:surgery; D019573:Epithelium, Corneal / Q000473:pathology*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D054018:Lasers, Excimer / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D013524:Surgical Flaps