title: Epithelial breakthrough during IntraLase flap creation for laser in situ keratomileusis.
abstract: 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.
authors.affiliation: Bascom Palmer Eye Institute, Miami, Florida 33136, USA.
authors.forename: Michael I
authors.initials: MI
authors.lastname: Seider
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ide
authors.forename: George D
authors.initials: GD
authors.lastname: Kymionis
authors.forename: William W
authors.initials: WW
authors.lastname: Culbertson
authors.forename: Terrence P
authors.initials: TP
authors.lastname: O'Brien
authors.forename: Sonia H
authors.initials: SH
authors.lastname: Yoo
mesh_terms: 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