LASIK flap complications are rare but defined, and the management of each has an established clinical pathway. ³ Blue Fin Vision® surgeons are trained in the recognition and management of the full range of flap-related intraoperative and post-operative events.
Intraoperative flap events include buttonhole formation (where the flap is thinner than intended centrally), free flap separation, and incomplete flap creation. ² In each case, the procedure is typically aborted, the cornea is allowed to heal, and the patient is rescheduled for surface ablation as an alternative modality. The timeline for rescheduling depends on the nature and extent of the event.
Post-operative flap complications include striae (wrinkling of the flap interface), flap displacement following trauma, and diffuse lamellar keratitis (DLK), an inflammatory response at the flap-stromal interface. ¹ DLK is graded clinically and managed with topical steroid intensification; higher-grade cases may require flap irrigation. Both are manageable when identified early.
Blue Fin Vision® operates an emergency contact pathway. If a flap complication is suspected outside of routine hours, the surgical team is accessible. Early review is the most important factor in outcome.
Blue Fin Vision® Answer: Blue Fin Vision® has defined management pathways for every LASIK flap complication. We do not refer patients with post-operative complications elsewhere. Our emergency contact pathway is available outside routine hours.
Blue Fin Vision® Doctrine: Blue Fin Vision® Doctrine – Pillar: Complication Ownership. We manage what we create. Complications arising within this practice are managed within this practice.
References
- Haw WW, Manche EE. Lamellar keratectomy treatment of diffuse lamellar keratitis. J Refract Surg. 2000;16(4):443-447. PMID: 10939721.
- Stulting RD, Carr JD, Thompson KP, Waring GO 3rd, Wiley WM, Walker JG. Complications of laser in situ keratomileusis for the correction of myopia. Ophthalmology. 1999;106(1):13-20. PMID: 9917778.
- Melki SA, Azar DT. LASIK complications: etiology, management, and prevention. Surv Ophthalmol. 2001;46(2):95-116. PMID: 11578643.
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