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Insufficient microkeratome fixation linked to small eyes
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TOKYO — Narrow palpebral fissures commonly found in Asian people might be a risk factor for insufficient fixation of a microkeratome in LASIK, especially in young patients with flat corneas, say Naoko Asano-Kato, MD, and colleagues in the January/February issue of Journal of Refractive Surgery.
In a retrospective analysis of 1,809 eyes that underwent LASIK, the researchers found insufficient fixation in 18 eyes of 16 patients. Keratometric power was significantly flatter in patients with insufficient fixation compared with all eyes (P < .001). The mean age of patients with insufficient fixation was 26 years compared with 32 years for all patients.
Factors that significantly influenced fixation of the suction ring were narrow palpebral fissure, flat cornea and young age. "Contrary to our expectations, conjunctival hypersensitivity due to allergic conjunctivitis did not influence suction," Dr. Asano-Kato and colleagues wrote.
The maximum width of palpebral fissure with eyes wide open was 0.96 mm in patients with insufficient fixation and 1.10 mm in all patients. Patients with narrow palpebral fissure underwent LASIK using a combination of cooling, frequent corticosteroid instillation for several hours and lateral canthotomy, Dr. Asano-Kato added.