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LASIK flap complications infrequent but can lead to aborted procedures

Issue: November 2016

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NEW YORK — Abandoned LASIK flap procedures due to complications are uncommon, but a second surgery can still result in positive outcomes for patients if surgeons optimize timing and their surgical technique, a speaker said here.

“The good news is even when we experience these significant complications at the time of LASIK elective procedures, we can tell our patients that we can still get them good outcomes. While we have to wait a little bit longer for microkeratome flaps to maybe stabilize, the nice thing that we looked at with the femto flaps is that refractions are very stable at 1 week. If it’s not, certainly don’t proceed and wait for refractive stability. But if it is, then our patients actually did very well with a surface ablation procedure,” Priyanka Sood, MD, said at OSN New York 2016.

Priyanka Sood

Complications occur in LASIK procedures using a microkeratome blade between 0.4% to 10% of the time, while complications occur in procedures using a femtosecond laser between 0.67% to 15% of the time. Procedures using a microkeratome blade had to be abandoned due to complications 0.6% to 1.7% of the time compared with femtosecond laser procedures being abandoned due to complications 0.68% to 1.6% of the time, Sood said.

Sood said re-treatment after aborted microkeratome blade flap procedures typically results in excellent visual outcomes, but surgeons should wait 2 to 3 months before re-treatment.

Refractions after aborted femtosecond laser procedures are typically stable at 1 week, and surface ablation over aborted flaps results in excellent visual outcomes. A second surgery is safe within 2 weeks of the aborted procedure, she said. – by Robert Linnehan

Reference:

Sood P. Retreatments after LASIK flap complication: Optimal timing? Presented at: OSN New York annual meeting; Nov. 4-6, 2016; New York.

Disclosure: Sood reports no relevant financial disclosures.