Increased risk for flap dislocation with perioperative brimonidine use in femtosecond laser in situ keratomileusis

Muñoz, Gonzalo; Albarrán-Diego, César; Sakla, Hani F.; Javaloy, Jaime

doi:10.1016/j.jcrs.2009.03.029

Cited by 14 publications

(12 citation statements)

References 18 publications

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“…44 Fifth, because the suction is applied to the peripheral cornea and not the bulbar conjunctiva, subconjunctival hemorrhage is rare and there is no need for vasoconstrictor eyedrops. Muñoz et al 45 compared subconjunctival hemorrhages and dellen formation using the IntraLase laser. They found an incidence of clinically significant hemorrhages in 83.6% of eyes without brimonidine and in 14.9% with brimonidine and a 4.5% rate of dellen formation in cases with large hemorrhages.…”

Section: Discussionmentioning

confidence: 99%

Femtosecond laser flap parameters and visual outcomes in laser in situ keratomileusis

Issa¹,

Hassany²

2011

Journal of Cataract and Refractive Surgery

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Section: Discussionmentioning

confidence: 99%

Femtosecond laser flap parameters and visual outcomes in laser in situ keratomileusis

Issa¹,

Hassany²

2011

Journal of Cataract and Refractive Surgery

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“…17 Preoperative brimonidine 0.2% has been associated with rates of flap striae or dislocation as high as 12.8% 18,19 ; in other studies, neither brimonidine 0.2%, dilute brimonidine, nor apraclonidine have been associated with flap adherence issues. [20][21][22] Femtosecond flaps have been shown in a rabbit model to have stronger adhesion strength than microkeratome flaps, although this may have more bearing on late dislocation rather than early dislocation.…”

Section: ' Introductionmentioning

confidence: 93%

LASIK Flap

Estopinal¹

2016

International Ophthalmology Clinics

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Laser-assisted in situ keratomileusis (LASIK) surgery is among the most common operations in the world. It is estimated that over 15 million patients have undergone LASIK, and approximately 95% of these patients are satisfied after their operation. 1 Advances in instrumentation, such as the introduction of femtosecond laser technology for flap creation, have improved the predictability of creating flaps and safety profile of LASIK surgery. 2-4 The LASIK flap allows for rapid visual recovery with minimal pain 5 ; however, LASIK flap-associated postoperative complications do occur. Overall complication rates are low, with several large series reporting complication rates of <1% to 1.8%, which tend to decrease with surgeon experience. 6-9 Post-LASIK flap-related complications can be organized into early postoperative complications, occurring within 72 hours of the operation, and late postoperative complications, occurring Z72 hours after the operation (Table 1). Given the low but real risk of postoperative flap complications, it is imperative that the refractive surgeon is well versed in the diagnosis and management of postoperative complications associated with the LASIK flap. ' Early Postoperative Complications Mechanical Flap Complications: Flap Striae and DisplacementThe LASIK flap can be wrinkled or displaced postoperatively, most commonly presenting on the first postoperative day. LASIK flap striae occur when the flap has folds in itself, usually because of initial misalignment of the flap, small movements of the flap, or ''tenting'' of

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“…In their article about flap dislocation, 1 Muñ oz et al state that topical brimonidine prevents the formation of subconjunctival hemorrhages after femtosecond laser in situ keratomileusis (LASIK) but significantly increases the risk for early flap dislocation. I offer some plausible explanations for the observed flap dislocation.…”

Section: Early Flap Dislocation With Perioperative Brimonidine Use Inmentioning

confidence: 99%

Early flap dislocation with perioperative brimonidine use in laser in situ keratomileusis

Nowroozzadeh¹

2010

Journal of Cataract and Refractive Surgery

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cases of combined phacoemulsification and silicone oil removal. J Cataract Refract Surg 2009; 35:1190-1192 2. Ianchulev T, Salz J, Hoffer K, Albini T, Hsu H, LaBree L. Intraoperative optical refractive biometry for intraocular lens power estimation without axial length and keratometry measurements. J Cataract Refract Surg 2005; 31:1530-1536 3. Mackool RJ. The cataract extraction-refraction-implantation technique for IOL power calculation in difficult cases. J Cataract

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Increased risk for flap dislocation with perioperative brimonidine use in femtosecond laser in situ keratomileusis

Abstract: Brimonidine prevented the formation of subconjunctival hemorrhages after femtosecond LASIK but increased the risk for flap dislocation. Thus, surgeons are cautioned against the use of perioperative brimonidine to decrease hemorrhagic complications in femtosecond LASIK.

Cited by 14 publications

References 18 publications

Femtosecond laser flap parameters and visual outcomes in laser in situ keratomileusis

Femtosecond laser flap parameters and visual outcomes in laser in situ keratomileusis

LASIK Flap

Early flap dislocation with perioperative brimonidine use in laser in situ keratomileusis

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