title: Intraoperative flap re-cut after vertical gas breakthrough during femtosecond laser keratectomy.
abstract: We describe the management of intraoperative vertical gas breakthrough (VGB) during femtosecond laser flap creation in 3 patients. All eyes were immediately re-cut using 2 different microkeratomes, and the laser in situ keratomileusis treatments were completed on the same day. There were no postoperative complications. Corneal abrasion might predispose to VGB. Management of VGB is effective using microkeratomes. Caution is advised during placement of the suction ring and in eyes with preexisting corneal abrasion or loose epithelium if femtosecond laser keratectomy is used. The approach in terms of direction of the microkeratome re-cut is fundamental to the safety and successful re-cut with a microkeratome.
authors.affiliation: Department of Ophthalmology, Guy Hugh Chan Refractive Surgery Centre, Hong Kong Sanatorium and Hospital, Hong Kong, China. johnchangsm@gmail.com
authors.forename: John S M
authors.initials: JS
authors.lastname: Chang
authors.forename: Silvania
authors.initials: S
authors.lastname: Lau
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000601:surgery*; D003319:Corneal Stroma / Q000601:surgery*; D005260:Female; D005740:Gases; D006801:Humans; D007431:Intraoperative Complications; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D012086:Reoperation; D013524:Surgical Flaps; D014792:Visual Acuity
chemical_list: D005740:Gases