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Chapter-17 Garg's and Chaudhary's LASIK Complications

BOOK TITLE: Lasik and Lasik Complications

Author
1. Garg Ashok
2. Chaudhary Sanjay
ISBN
9788184482324
DOI
10.5005/jp/books/10443_17
Edition
1/e
Publishing Year
2008
Pages
5
Author Affiliations
1. Garg Eye Institute and Research Center, 235-Model Town, Dabra Chowk, Hisar, India, Garg Eye Institute and Research Centre, Hissar, Haryana, India, Garg Eye Institute and Research Centre, 235, Model Town, Dabra Chowk, Hisar-125005, India, Jaipur Heart Institute, Jaipur, Rajasthan, India, Garg Eye Institute and Research Centre, 235-Model Town, Dabra Chowk Hisar-125005, Haryana, India, 235, Model Town, Dabra Chowk, Hisar, Haryana, India, Garg Eye Institute and Research Centre, Hisar, India, Garg Eye Institute and Research Centre, Model Town, Dabra Chowk, Hisar, India, President, Intraocular Implant and Refractive Society of India[IIRSI], Garg Eye Hospital, 235, Model Town, Dabra Chowk, Hisar, Haryana, India, Garg Eye Institute and Research Centre, Dabra Chowk, Hisar, Haryana, India, Garg Eye Institute and Research Centre, 235 Model Town, Dabra Chowk, Hisar-125005, Haryana, India, Garg Eye Institute and Research Centre, 235 Model Town, Dabra Chowk, Hisar, Haryana, India, Garg Eye Institute and Research Centre, 23
2. Chaudhary Eye Centre and Laser Vision, 4802, Bharat Ram Road, Ansari Road, 24, Darya Ganj, New Delhi, Chaudhary Eye Centre and Laser Vision, 4802, Bharat Ram Road, Ansari Road, 24, Darya Ganj, New Delhi, India, Chaudhary Eye Centre and Laser Vision, 4802, Bharat Ram Road, 24, Daryaganj, New Delhi, India, New Delhi, India, Chaudhary Eye Center and Laser Vision, New Delhi, India, Chaudhary Eye Centre and Laser Vision,. 4802, Bharat Ram Road, Ansari Road, 24, Darya Ganj, New Delhi, India, Chaudhary Eye Centre and Laser Vision, 4802, Bharat Ram Road, Ansari Road, 24, Darya Ganj, New Delhi–110002, 166 Military Hospital, C/O 56 APO, Chaudhary Eye Centre and Laser Vision Centre, 4802, Bharat Ram Road, Daryaganj, New Delhi, India
Chapter keywords

Abstract

Free flap: A 22 years old female with myopia of –5, 0D in both the eyes with prominent persistent papillary membrane was scheduled for Lasik surgery in the right eye. Operation done: The corneal flap was missing and a central circular exposed area of the cornea stroma was seen. Complication faced: free flap o free cap. Management of complication: 1. Management of the flap, the flap was held by a non-toothed forceps and placed in an anti-desiccation chamber, epithelial surface down; 2. Continue lasik, the Lasik ablation was continued as planned; 3. Repositioning the flap. The tricky part of the management is: it becomes very difficult to clinically differentiate the epithelial side of the flap from the stromal side. Placing the epithelial side on the corneal bed will result in epithelialisation of the stromal bed and a subsequent loss of the flap. Improper alignment of the flap. The incidence of free flaps in our clinical practice is 0, 5%. Corneal Haze after Lasek with mitomycin: A 26 years old male presented with bilateral high myopia and was scheduled for simultaneous bilateral alcohol assisted lasek surgery in both the eyes. After corneal ablation the cornea was cooled using chilled BSS and the treated area of cornea was then exposed to 0, 002% mitomycin-C for 60 seconds. The corneal surface was washed with BSS for a minute to remove all traces of mitomycin and then the epithelium was reposited back. A bandage contact lens was then placed on the eye. The epithelium healed in five days time. Mitomycin-C is useful in containing fibroblastic activity and reducing the chances of corneal haze. Complications: One and a half year later? Diminishing vision. A slit lamp examination: Superficial corneal haze in both the eyes. Management: low dose steroid drops three times a day for three months. Corneal Haze: The most feared complication in a long-standing follow-up of Lasek and can be graded from I to IV. Flap wrinkles: Extending into the papillary area. The wrinkles become very prominent once the flap is lifted. Slit-lamp exam on the following day reveals that the wrinkles are almost gone and the corrected vision improves to 6/6p. The incidence of flap wrinkles or striae in our clinical practice is 0, 6%.

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