Abstract
Purpose :
Laser in situ keratomileusis (LASIK) is the most widely performed keratorefractive surgery. Most complications of LASIK can be attributed to the corneal flap, and while many flap-related complications can be managed without aggressive surgical intervention, flap amputation is sometimes required. The purpose of this study was to describe the outcomes of flap amputation after LASIK.
Methods :
In this retrospective consecutive case series, medical records of patients who underwent LASIK flap amputation at Mayo Clinic, Rochester between January 1, 1999, and December 31, 2022, were retrospectively reviewed. The indication for flap amputation, additional interventions, and final visual outcome were determined.
Results :
Fifteen eyes (15 patients) underwent flap amputation during the study period. Mean age was 50 years (range, 25-71 years) and 8 (53%) patients were male. Mean best spectacle-corrected visual acuity (BSCVA) was 20/196 (Snellen range, 20/20-HM). Indications for flap amputation were infectious keratitis (n=6, 40%), epithelial ingrowth (n=6, 40%), diffuse lamellar keratitis (n=1, 7%), astigmatism from fixed flap striae (n=1, 7%), and persistent erosions (n=1, 7%). Adequate follow-up was available in 14 (93%) patients, with a mean duration of 4.1 years (range, 0.1-19.5 years). Further intervention included EDTA chelation in 1 (7%) patient, penetrating keratoplasty in 2 (14%) patients, and rigid contact lens fitting in 4 (29%) patients. Final mean central corneal thickness was 416 µm (range, 326-456 µm) and final mean BSCVA was 20/36 (20/20-20/200).
Conclusions :
LASIK flap amputation is sometimes necessary to control threatening corneal diseases. Excellent visual outcomes were achieved in most cases, albeit with additional intervention or rigid contact lens wear.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.