Kohnen T, Schwarz L, Remy M, Shajari M. Short-term complications of femtosecond laser-assisted laser in situ keratomileusis cuts: Review of 1210 consecutive cases.
J Cataract Refract Surg 2018;
42:1797-1803. [PMID:
28007112 DOI:
10.1016/j.jcrs.2016.11.029]
[Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 09/22/2016] [Accepted: 10/16/2016] [Indexed: 11/17/2022]
Abstract
PURPOSE
To evaluate short-term complications after femtosecond laser cuts for laser in situ keratomileusis (LASIK).
SETTING
Department of Ophthalmology, Goethe University, Frankfurt, Germany.
DESIGN
Retrospective consecutive case series.
METHODS
Consecutive femtosecond laser cuts (1210 cuts in 624 patients) from LASIK performed with the Intralase FS60 between 2006 and 2014 were analyzed. The analysis looked at intraoperative and postoperative complications at 1 day, 1 week, and 1 month and factors with potential impact on the complication rate, such as ablation depth.
RESULTS
No irregular, incomplete, or thin flaps, buttonholes, gas breakthrough, or free caps were observed. Intraoperatively, incomplete side cuts were observed in 4 cases (0.3%). Three of the 4 occurred during the first year of femtosecond laser usage and were explained by a software problem. Epithelial defects, limbal bleeding, and decentered flaps without negative impact on outcome were observed in 45 (3.7%), 12 (1.0%), and 5 (0.4%) eyes, respectively, on the treatment date. Diffuse lamellar keratitis (DLK) stage 1 was observed in 69 (5.7%), 36 (3.0%), and 3 (0.2%) eyes at 1 day, 1 week, and 1 month, respectively, and DLK stage 2 in 20 (1.7%), 6 (0.5%), and 2 (0.2%) eyes, respectively. An increase in total ablation depth resulted in a higher incidence of microstriae (P < .01 at 1 day, 1 week, and 1 month). An increase in the optical zone resulted in a significantly higher incidence of epithelial ingrowth at 1 day and 1 week (P < .01).
CONCLUSION
No major cut-related complications were observed. The femtosecond laser is a safe option to create a flap in LASIK.
FINANCIAL DISCLOSURE
Proprietary or commercial disclosures are listed after the references.
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