title: Artemis very high frequency digital ultrasound-guided femtosecond laser recut after flap complication.
abstract: Incomplete flaps are a relatively uncommon complication of laser-assisted in situ keratomileusis (LASIK) that occur when creation of the corneal flap is interrupted. Further complications can arise if a second flap is created that intersects the original flap interface, resulting in tissue slivers that can lead to more complications and poor visual outcomes. We report the case of a 56-year-old man who underwent LASIK in which an incomplete flap occurred after 45% completion using a mechanical microkeratome with a 160 µm head. The maximum depth achieved by this incomplete flap was measured by very high-frequency (VHF) digital ultrasound as 182 μm peripherally. Two months later, a second flap was created beneath the incomplete flap, at a depth of 190 μm. The resulting flap had a central thickness of 196 μm and a minimum clearance of 30 μm beneath the incomplete flap. This demonstrates a method for creating secondary flaps that may significantly reduce the risk of flap interface intersection.
authors.affiliation: London Vision Clinic, London, United Kingdom;; Department of Ophthalmology, Columbia University Medical Center, New York;; Centre Hospitalier National d'Ophtalmologie, Paris, France.
authors.forename: Dan Z
authors.initials: DZ
authors.lastname: Reinstein
authors.affiliation: London Vision Clinic, London, United Kingdom.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Dickeson
authors.affiliation: London Vision Clinic, London, United Kingdom.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Archer
authors.affiliation: London Vision Clinic, London, United Kingdom.
authors.forename: Marine
authors.initials: M
authors.lastname: Gobbe
mesh_terms: D003315:Cornea / Q000000981:diagnostic imaging; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D013524:Surgical Flaps / Q000473:pathology