Document Detail

Management of irregular astigmatism following rotationally disoriented free cap after LASIK.
MedLine Citation:
PMID:  18500089     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To illustrate the challenges associated with a misaligned free flap (cap) and to report the outcome of applying wavefront-guided customized photorefractive keratectomy (PRK) followed by conventional PRK ablation to correct residual refractive error and aberrations after LASIK free cap complications. METHODS: The clinical course and surgical interventions of two patients with free cap complications from LASIK surgery were reviewed. The first patient underwent a total of six interventions after the initial LASIK procedure, and the second patient underwent a total of five interventions. Interventions included cap lift, cap rotation, custom PRK, and conventional PRK enhancement with prophylactic topical mitomycin C (MMC). RESULTS: Customized PRK treatment and subsequent enhancements with prophylactic topical MMC led to the recovery of best spectacle-corrected visual acuity (BSCVA), neutralization of higher and lower order aberrations, and astigmatic neutrality. Symptoms related to higher order aberrations resolved in both patients. CONCLUSIONS: Wavefront-guided custom PRK for higher order aberrations followed by conventional PRK enhancement for residual lower order aberrations, both with topical MMC application, represents an efficacious strategy for treating patients with loss of BSCVA and visual symptoms due to LASIK free cap complications.
Virginia Miraldi Utz; Ronald R Krueger
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of refractive surgery (Thorofare, N.J. : 1995)     Volume:  24     ISSN:  1081-597X     ISO Abbreviation:  J Refract Surg     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-05-26     Completed Date:  2008-06-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505927     Medline TA:  J Refract Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  383-91     Citation Subset:  IM    
Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
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MeSH Terms
Alkylating Agents / administration & dosage
Astigmatism / etiology,  surgery*
Combined Modality Therapy
Corneal Stroma / surgery
Corneal Topography
Keratomileusis, Laser In Situ*
Lasers, Excimer*
Mitomycin / administration & dosage
Myopia / surgery*
Photorefractive Keratectomy / methods
Postoperative Complications*
Surgical Flaps / adverse effects*
Visual Acuity
Reg. No./Substance:
0/Alkylating Agents; 50-07-7/Mitomycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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