Complications of photorefractive keratectomy and laser in situ keratomileusis

J Refract Surg. 2003 Mar-Apr;19(2 Suppl):S247-9. doi: 10.3928/1081-597X-20030302-16.

Abstract

Purpose: To analyze the safety of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) with the Nidek EC-5000 excimer laser for surgery performed from Jan 1999 to Dec 2001.

Methods: Retrospective study of excimer laser in 683 eyes: PRK was performed in 103 eyes and LASIK was performed in 580 eyes using the Nidek EC-5000 excimer laser and Moria Carriazo Barraquer microkeratome. We classified complications as intraoperative, early postoperative (30 days) and late postoperative complications. All patients were followed for at least 6 months.

Results: There were 15 (2.19%) intraoperative microkeratome-related flap complications, 5 thin flaps (0.73%), 4 free caps (0.58%), 3 buttonholes (0.43%), and 3 small flaps (0.43%). The most frequent early postoperative complication was dry eye with pain in 42 eyes. There were 30 cases of microwrinkled flaps (4.39%), 14 cases of dislocated flaps or flap striae that necessitated lifting and irrigating the flap (2.04%), 8 interface epithelial ingrowth (1.17%), 4 interface debris (0.58%), 3 haze (0.43%), 3 glare (0.43%), 2 decentered ablations (0.29%), and 2 cases of toxic keratitis (0.29%). Late postoperative complications were 98 cases of spherical equivalent refraction more than or equal to 1.00 D (14.3%) with 6 months follow-up. Reoperation was necessary in 33 eyes (4.83%). Five eyes lost 1 or more lines of preoperative best spectacle-corrected visual acuity (0.73%), and 2 eyes had keratoconus (0.29%).

Conclusion: Refractive surgery with the Nidek EC-5000 excimer laser was safe, with few complications.

MeSH terms

  • Humans
  • Intraoperative Complications
  • Keratomileusis, Laser In Situ / adverse effects*
  • Lasers, Excimer
  • Photorefractive Keratectomy / adverse effects*
  • Postoperative Complications
  • Refraction, Ocular
  • Refractive Surgical Procedures*
  • Retrospective Studies
  • Safety
  • Surgical Flaps / adverse effects
  • Time Factors
  • Treatment Outcome
  • Visual Acuity