Intraoperative flap‑related complications in FemtoLASIK surgeries performed with Visumax� femtosecond laser: A ten‑year Romanian experience

Abstract

Incidence and clinical results of intraoperative flap and interface-related complications were investigated after Femtosecond-LASIK surgery, where flap creation was performed with VisuMax ® femtosecond laser. A retrospective 10-year cohort study was conducted including all eyes treated for all refractive errors by Femtosecond-LASIK technique. All the flaps were made by the same refractive surgeon with the VisuMax ® (Carl Zeiss Meditec) femtosecond laser. We report the intraoperative flap and interface-related complications in these eyes, also describing their management. The study included 4,032 eyes. Flap and interface-related complications were: opaque bubble layer (OBL) 21.18%, suction loss 1.29%, difficult docking 0.69%, difficult dissection of the flap 0.59%, bleeding from limbal blood vessels 0.35%, de-epithelialization of the flap 0.12%, and interface debris 0.025%. These situations were appropriately addressed, with favorable outcomes. Flap creation is an important step in LASIK surgery. The predictability and safety have improved since the flap incision is assisted by a femtosecond laser, but complications of the flap and interface can still occur during the flap creation. Refractive surgeons should be aware and properly manage any unusual situation.

Femtosecond‑LASIK outcomes using the VisuMax®‑MEL® 80 platform for hyperopia and hyperopic astigmatism refractive surgery

“…Patients unable to understand the perioperative management, patients with unreasonable expectations or patients unable to sign the informed consent were excluded as well ( 1 , 33 ).…”

“…Inclusion and exclusion criteria. The inclusion criteria for the surgery were: Patients of age ≥22 years, no refractive change for at least 2 years before surgery, stable peripheral retina (normal or already treated by laser photocoagulation if at-risk peripheral lesions were present), central endothelial density ≥2,000 cells/mm 2 and good compliance (1,3,33,34).…”

“…There are numerous previous reports of hyperopic LASIK showing various safety, efficiency and predictability percentages ( 6-32 ). The new femtosecond laser technology to perform LASIK flaps avoids many complications of the mechanical microkeratome (free caps, incomplete, irregular or displaced flaps), being presently preferred by many surgeons ( 1 , 2 , 33 ). In this study, we evaluated the safety, efficacy, predictability and accuracy of the refractive results of Femtosecond-LASIK (Femto-LASIK) procedure using the VisuMax ® -MEL ® 80 platform for hyperopia with or without astigmatism.…”

Corneal topography in preoperative evaluation for laser keratorefractive surgery – a review

“…Laser keratorefractive surgery has numerous contraindications, both systemically and locally, of which the corneal ectatic disorders are the most important to recognize at the preoperative evaluation in order to exclude these cases from surgery [ 1 - 3 ]. Therefore, corneal topography is probably the most important investigation in preoperative screening and should be performed in all patients addressed for laser refractive surgery [ 1 , 2 ].…”

[Editorial] 2nd Special Issue: Tackling key immunological and immuno-dermatological pathways and their link to treatment options

“…Tăbăcaru et al (34) aimed to investigate the incidence and clinical results of intraoperative flap and interface-related complications after Femtosecond-LASIK surgery, where flap creation was performed with VisuMax ® femtosecond laser and conducted a retrospective 10-year cohort study including all eyes treated for all refractive errors by Femtosecond-LASIK technique. The predictability and safety have improved since the flap incision is assisted by a femtosecond laser, but complications of the flap and interface can still occur during the flap creation.…”