Posters

Laser in situ keratomileusis intraoperative complications using microkeratome in a large series of cases: incidence, types, risk factors

Poster Details

First Author: A.Llovet-Rausell SPAIN

Co Author(s):    F. Llovet-Osuna   J. Ortega-Usobiaga   M. Cabanás              

Abstract Details

Purpose:

To evaluate the incidence, types and risk factors of microkeratome complications that occur during laser in situ keratomileusis (LASIK)

Setting:

Clinica Baviera - AIER EYE Group

Methods:

A retrospective, noncomparative, study conducted on 725,832 eyes who underwent primary LASIK by 367 surgeons between December 1996 and February 2020 at Clínica Baviera/Care-Vision - AIER EYE Group (40 refractive surgery centers of 4 countries –Spain, Italy, Germany, Austria-), using four types of microkeratomes (Moria One, Hansatome XP, Moria 2 and Moria SBK). All cases with microkeratome complications and especially those that led to abandonment of the LASIK procedure were identified.

Results:

Intraoperative complications occurred in 68218 eyes (9.398%), of which in 1531 (0.210% of the total procedures) cases treatment was abandoned. Complications were grouped: 1054 (0.154%) thin flaps and donut-shaped flaps (Buttonholes), 5416 (0.746%) epithelial abrasion, 12 (0.002%) flap loss, 7763 (1.070%) free caps, 4922 (0.678%) incomplete pass, 47050 (6.482%) intraoperative bleeding, 1461 (0.201%) irregular flap, 429 (0.059%) partial flap and 111 (0.015%) other problems. No case of corneal perforation. When were stratified according to preoperative keratometric power, eyes with flatter corneas had more free caps and partial flaps (p <0.0001), but no relationship was found with the incidence of buttonholes.

Conclusions:

Excluding bleeding, the incidence of intraoperative complications was found to be low on LASIK using the microkeratome. The presence of incomplete flap or buttoholes were the main reasons for suppressing the treatment. No statistically significant relationship was found between preoperative keratometric power and incidence of flap buttonholes in this series. Eyes with flatter corneas tended to have more free caps and partial flaps.

Financial Disclosure:

None