Early flap displacement after LASIK: how is the real final outcome of these eyes?

Session Details

Session Title: Moderated Poster Session: Refractive

Session Date/Time: Saturday 05/09/2015 | 14:00-15:00

Paper Time: 14:10

Venue: Poster Village: Pod 1

First Author: : R.Cobo-Soriano SPAIN

Co Author(s): :    F. Llovet   F. Gonzalez-Lopez   R. Bilbao   J. Beltran     

Abstract Details

Purpose:

RATIONALE STATEMENT: Flap displacement has traditionally been catalogued as a benign postoperative complication of LASIK. However, an eye with a corneal flap that has remained wrinkled for several hours in the postoperative period, usually has a late restoration of visual performance compared with eyes with a perfect postoperative healing and fitting between both, flap and stromal surfaces. Purpose:

To evaluate in a large sample of cases, the refractive and visual outcomes of eyes that suffered from an early postoperative flap dislocation.

Setting:

Clinica Baviera Group, Madrid, Spain.

Methods:

.Retrospective and comparative study analyzing the refractive and visual outcomes of a large sample of eyes (n= 459) that suffered a postoperative early flap dislocation (within 48h after LASIK procedure) at our Institution (24h-emergency Service), and comparing them with a control normal postoperative LASIK group. Postoperative final visual data ((mean UDVA, mean DCVA, efficacy and safety parameters), and postoperative final refractive data (spherical equivalent, percentage of eyes within ±0.5D and rate of enhancement)) were analyzed and compared between both groups.

Results:

Time between flap dislocation and surgical reposition was: same day (n=149, 32.5%), first day (n= 278, 60.5%), and second day (n=32, 7%). Main outcome measures were the following: In the dislodged-flap group, efficacy (postoperative UDVA minus preoperative DCVA) was 61%, safety (loss of ≥2 lines between postoperative and preoperative DCVA,) was 4.7%, predictability (% eyes ±0.5D) was 75%, and enhancement rate 12%. In the control group, efficacy was 75%, safety 1.5%, predictability 86.2% and percentage of enhancement 6.7%. Comparison between both groups showed statistically significant differences in all these parameters. We also describe anatomical complications of some specific significant cases.

Conclusions:

A flap dislocation after a LASIK procedure changes the final prognosis and worsens the visual performance, predictability and the rate of enhancement despite a prompt surgical reposition.

Financial Interest:

NONE