Intraoperative Complications of Lasik

Several complications may arise during lasik eye surgery. Some of the complications are due to the operating surgeon and some are due to faulty preoperative preparation and some are due to some patient factors.

Flap complication:

This is a complication of lasik eye surgery during operative procedure although some flap complications may also occur postoperatively. It is reported that the incidence of flap complication in lasik eye surgery is approximately 0.25%. Some of the flap complication may necessitate flap repositioning. Sometimes repositioning of flaps may be required due to displacement of flaps. Flap complications are common in lamellar corneal surgeries, although only rarely leads to vision permanent problems. Diffuse lamellar keratitis, and epithelial ingrowth are also seen as complication, which can be generally controlled satisfactorily.

Corneal flap may be detached from the rest of cornea (called slipped flap) and is a common flap complication. The risk is highest immediately after surgery.

Particles in flap interface:

This is another very common complication although the clinical importance/significance is not yet clear, as it usually does not give rise to any problem. Most (almost 100%) of the patients who underwent lasik eye surgery can be demonstrated to have particles in flap interface by using confocal microscopy.

How to prevent/reduce intra-operative complications of lasik eye surgery?

Many experts believe, the microkeratome-related complications can be reduced by use of intralasik technique and other non-microkeratome related approaches, although it has its own complications. The flap complication rate can also be reduced by the experience of the ophthalmic surgeon.

The incidence of slipped flap may be reduced by operating faster as it will not allow the flaps to dry, which may be one of the reason of slipped flap. As the risk of slipped flap is highest immediately after surgery, the patient should be advised to go home and sleep to let the flap heal or keep the patient in hospital and allowed to sleep for healing of flap. The patient also should be given sleep goggles or eye shields to wear for several nights, as it will prevent the flap to dislodge during sleep.



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