title: Microkeratome complications.
abstract: OBJECTIVE
  Complications from laser in-situ keratomileusis surgery are extremely rare. However, most of the complications involve construction of the corneal flap, which is fashioned using various mechanical or femtosecond laser microkeratomes. Here, we review and discuss complications of microkeratome flaps.
  
  
  RESULTS
  Several large studies of microkeratome laser in-situ keratomileusis cases report a similar set of complications: partial or irregular flaps, buttonholes, and free flaps. Risk factors for these complications include increased age, preoperative hyperopia, and years of contact lens wear. Numerous animal and clinical studies have shown that the femtosecond platform produces flaps with greater stability with more consistent and accurate dimensions than the mechanical microkeratome. However, there is no significant difference in final visual outcome.
  
  
  CONCLUSIONS
  The aim of this review is to report complications associated with mechanical microkeratomes in the construction of laser in-situ keratomileusis flaps and to see whether there is a significant disadvantage compared with the femtosecond laser.
authors.affiliation: Yale Eye Center, New Haven, Connecticut 06510, USA. jimmy.k.lee@yale.edu
authors.forename: Jimmy K
authors.initials: JK
authors.lastname: Lee
authors.forename: Esi W
authors.initials: EW
authors.lastname: Nkyekyer
authors.forename: Roy S
authors.initials: RS
authors.lastname: Chuck
mesh_terms: D003315:Cornea / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D012307:Risk Factors; D013524:Surgical Flaps; D016896:Treatment Outcome; D014792:Visual Acuity