Posters

Superior central crater: an unusual eximer laser ablation complications resulting from eximer laser system failure

Poster Details

First Author: R.Odeyar INDIA

Co Author(s): S. Shaha                    

Abstract Details

Purpose:

To  present  a  very rare case of  superior  central crater an  unusual  ablation complication  resulting from malfunctioning of eximer laser delivery system and to  make  refractive  surgeons  aware  that   eximer  laser  systems   can  go  wrong  any  time   and  conscious   and  timely    intervention  can  prevent   devastating   complication  like perforation  of  cornea.

Setting:

Swapnil Eye and Laser Centre

Methods:

A  21  year  old  female  patient  with  refraction of  -1.25 diaptor   sphere and -1.25 diaptor cylinder 130 degree   cylinder  in OD  and   -5.50 sphere in OS and  corneal thickness  of   531 and   535 microns in  OD and  OS  respectively  came for LASIK. After    completion  of  flap in  OD   ablation was   started . An   unusual   pattern   of  ablation  at  single point   was  noticed. Immediately   the  treatment   was   stopped   withithin  4 seconds   of   starting treatment. Fluience   test   was  taken   which  came  out  to  be  very  abnormal Flap  was  repositioned   machine   switched   off   and  started  again  after  10  minutes  . Fluence   test repeated   again   three   times   which  came  out  to  be  normal   Flap  reopened   and   treatment  completed   with   80%  of  desired   ablation  of  -1.25   sphere   and           -1.25 cylinder   @  130   degrees

Results:

Topography   showed    a  superior   central   flattening   and  V/A  on first post operative   day was    6/12  J/3  which   improved   to   6/9    J/2  after  50 th day   On   topographic   examination    on  50 postoperative  day   area  of  flattening  was seen  though  reduced  in  size. Service engineer  found that laser delivery system was malfunctioning which was changed. Same   ablation  was  done   on  eight   goats   eyes   after  getting  the   servicing   of   laser   machine   which came out  to be     normal.

Conclusions:

More  damage  was  prevented  by  timely  recognition  of  complication .And  useful   un  corrected  V/A  of 6/9 J/2(p)  restored  at  50  th  day  postoperatively  and total corneal perforation was prevented.

Financial Disclosure:

None