Reinstein Dan Z, Dickeson Zachary, Archer Timothy J, Gobbe Marine
London Vision Clinic, London, United Kingdom;; Department of Ophthalmology, Columbia University Medical Center, New York;; Centre Hospitalier National d'Ophtalmologie, Paris, France.
London Vision Clinic, London, United Kingdom.
Digit J Ophthalmol. 2014 Sep 14;20(3):43-57. doi: 10.5693/djo.02.2014.01.003. eCollection 2014.
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.