One-step transepithelial photorefractive keratectomy with mitomycin C as an early treatment for LASIK flap buttonhole formation.
OBJECTIVE
To assess the efficacy and safety of early one-step transepithelial photorefractive keratectomy (PRK) with mitomycin C as treatment for buttonhole formation during LASIK.


METHODS
Eight patients who developed a buttonhole during LASIK with mechanical or femtosecond flap creation underwent one-step transepithelial PRK a few days after the formation of the buttonhole. The re-treatment procedure was performed after complete epithelial healing and smooth epithelial fluorescein profile were ensured. Postoperative manifest refraction, uncorrected and corrected distance visual acuity, and haze formation were assessed during 6 months of follow-up.


RESULTS
Mean duration of the re-treatment procedure after buttonhole formation was 5 days (range: 4 to 7 days). Mean manifest refractive spherical equivalent and cylinder refraction were -0.05 ± 0.18 and -0.18 ± 0.22 diopters, respectively, at 6 months postoperatively. Uncorrected distance visual acuity was 20/20 in all patients after 3 months of follow-up. No haze formation was detected.


CONCLUSIONS
Early one-step transepithelial PRK with mitomycin C seems to be a safe and effective treatment for LASIK buttonhole complication.
Marwan R
MR
Abdulaal
Hanine A
HA
Wehbe
Shady T
ST
Awwad
D000328:Adult; D003432:Cross-Linking Reagents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects* / Q000379:methods; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use*; D009216:Myopia / Q000601:surgery*; D018903:Photorefractive Keratectomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology*; D012086:Reoperation; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
D003432:Cross-Linking Reagents; D016685:Mitomycin