Purpose: To describe the incidence, management, and visual outcomes of buttonholed laser in situ keratomileusis (LASIK) flaps.
Setting: Private practice, Riyadh, Saudi Arabia.
Methods: This retrospective review identified eyes that developed buttonholed flaps during LASIK. Preoperative, intraoperative, and postoperative data were obtained to identify factors predictive of this complication.
Results: Of 4250 primary LASIK procedures, 17 eyes (0.4%) with buttonholed flaps were identified. Buttonholes occurred with the Hansatome microkeratome in 64.7% of eyes and with the Moria microkeratome in 35.3% of eyes, the incidence of buttonholed flaps was 0.62% and 0.19%, respectively (P = .03). Laser ablation was performed at the same time as buttonhole formation in 8 eyes (47.1%) and was aborted in the other eyes. Retreatment was performed in 10 eyes (58.8%); of retreated eyes, 6 had repeat LASIK and 3 had surface ablation. The final spherical equivalent refraction was -0.38 diopter +/- 0.79 (SD). Two eyes had a final loss of more than 2 lines of best corrected visual acuity (BCVA). The mean loss of BCVA lines was 0.72 in eyes that had complete LASIK, 0.62 in eyes that had aborted LASIK followed by retreatment with repeat LASIK, and 0.80 in eyes that had aborted LASIK followed by retreatment with surface ablation.
Conclusions: Buttonholed flaps occurred more frequently in the second of 2 consecutively treated eyes. Microkeratomes that produce a larger diameter flap were more likely to produce flap buttonholes. The least loss of BCVA was achieved when LASIK was aborted and then repeated after refractive stability.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jcrs.2009.01.013 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Surgical Technique of Glans Wings Creation with Preservation of Glanular Vascular Arcade and Creating Flaps for Tension-Free Glansplasty in Hypospadias Repair.
Urol Res Pract
January 2023
Department of Pediatric Surgery, King George's Medical University, Uttar Pradesh, Lucknow, India.
Objective: The objective of this study is to report the technical nuances of glans wings creation in anatomical plane facilitating liberal glans wings mobilization with preservation of glanular vessels for tension-free glansplasty in surgery of hypospadias in primary and redo cases.
Materials And Methods: Eighty-six primary hyposapdias and 7 cases of distal hypospadias, operated elsewhere and presented with glans and urethroplasty dehiscence, undergoing tubularized-incised-plate (TIP) repair were included after ethical approval. Technical points of glans wings creation in the subfascial plane included (i) creation of Buck's fascia window, just proximal and lateral to the point of bifurcation of corpus spongiosum, (ii) creation of subfascial-pret unical plane on the tunica albuginea of corpora cavernosa up to ventral limit of laid open glanular meatus, (iii) release of pillars of corpus spongiosum off the glans base keeping the basal lamina propria covering the vascular arcade intact, (iv) release of glans base off the tip of corpora cavernosa and composite flap of corpus spongiosum pillars with Buck's fascia off the corpora cavernosa, (v) approximation of glans wings over the tubularized-incised-plate covered with dartos, and (vi) approximation of fasciospongioplasty flaps at hypospadiac meatus.
Urethral Plate Substitution in Two-Stage Hypospadias Repair: Grafts Versus Flaps.
J Pediatr Surg
October 2023
Department of Pediatric Surgery, Faculty of Medicine-Ain Shams University, Cairo, Egypt.
Background: Choosing between flaps or grafts to substitute the urethral plate in 2-stage hypospadias repair has been a matter of debate with no consensus in the literature. Flaps have reliable blood supply that maybe theoretically less liable for strictures or contractures. Grafts are more versatile, which can be used in primary and recurrent cases when healthy local skin is deficient.
View Article and Find Full Text PDFSurgical success of 'W' shaped incision versus Tear Trough incision in External Dacryocystorhinostomy.
Orbit
October 2022
Department of Ophthalmology, University College of Medical Sciences (Ucms), Guru Teg Bahadur (Gtb) Hospital, Delhi, India.
Article Synopsis
- The study aims to compare the effectiveness of 'W' shaped and tear-trough incisions in external dacryocystorhinostomy (eDCR) for treating chronic dacryocystitis.
- It involved 61 eyes from patients, assessed based on cosmetic and functional outcomes after 3 months, with both objective and subjective metrics used to measure success.
- The results showed that both incision types had similar rates of functional and anatomical success, with slight differences in complications and subjective cosmetic ratings, ultimately concluding that the 'W' shaped incision is as effective as the traditional tear-trough incision.
Complications of laser-assisted keratomileusis.
Indian J Ophthalmol
July 2021
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Article Synopsis
- LASIK is a popular eye surgery that has developed significantly since its 1990 introduction, aiming to enhance vision outcomes.
- Intraoperative and postoperative complications can arise during the procedure, though they are relatively rare, and can include issues like flap tears and residual refractive error.
- The review focuses on understanding the risk factors and management strategies for these complications to improve prevention, early detection, and effective treatment for better visual results.
Effect of Transepithelial Photorefractive Keratectomy without Mitomycin C in the Treatment of Femtosecond Laser In Situ Keratomileusis Corneal Flap Complications.
J Ophthalmol
January 2021
Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei 230601, China.
Article Synopsis
- The study evaluates the safety and efficacy of transepithelial photorefractive keratectomy (TPRK) without mitomycin C for treating complications from femtosecond laser in situ keratomileusis (FS-LASIK) surgeries.
- Eight patients with various corneal flap complications were treated using TPRK, with follow-up assessments over six months on vision and haze formation.
- Results indicated that TPRK was safe, with all patients achieving good visual acuity (better than 20/25) and no signs of haze after treatment.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!