Paper Information

Journal:   JOURNAL OF OPHTHALMIC AND VISION RESEARCH   2016 , Volume 11 , Number 3; Page(s) 263 To 267.
 
Paper: 

INTRAOPERATIVE FLAP COMPLICATIONS IN LASIK SURGERY PERFORMED BY OPHTHALMOLOGY RESIDENTS

 
DOI: 

10.4103/2008-322X.188393

 
Author(s):  ROMERO DIAZ DE LEON LORENA, SERNA OJEDA JUAN CARLOS, NAVAS ALEJANDRO, GRAUE HERNANDEZ ENRIQUE O., RAMIREZ MIRANDA ARTURO*
 
* DEPARTMENT OF CORNEA AND REFRACTIVE SURGERY, INSTITUTO DE OFTALMOLOGIA CONDE DE VALENCIANA, CHIMALPOPOCA 14, CUAUHTEMOC 06800, MEXICO CITY, MEXICO
 
Abstract: 

Purpose: To report the rate of flap?related complications in LASIK surgery performed by in?training ophthalmology residents and to analyze the risk factors for these complications.
Methods: We analyzed 273 flap dissections in 145 patients from March 2013 to February 2014. We included all LASIK surgeries performed by 32 ophthalmology residents using a Moria M2 microkeratome. All the flap?related complications were noted. Comparison between both groups with and without complications was performed with an independent Student’st ?test and relative risks were calculated.
Results: There were 19 flap?related complications out of the 273 flap dissections (6.95%). The most common complication was incomplete flap dissection (n=10, 3.66%), followed by free?cap (n=5, 1.83%), and flap?buttonhole (n=2, 0.73%). There was no significant difference between the complicated and uncomplicated cases in terms of the right versus the left eye, pachymetry results, white?to?white diameter, and spherical equivalent. But this difference was significant for mean keratometry (P=0.008), K?min (P=0.01), and K?max (P=0.03) between these groups. Final visual acuity after rescheduling laser treatment was similar in both groups. Relative risks for flap?related complications were 2.03 for the first LASIK surgery (CI 95% 0.64 to 6.48, P=0.22) and 1.26 (CI 95% 0.43 to 3.69, P=0.66) for the surgeon’s flap?elated complications. Female gender presented an odds ratio of 2.48 (CI 95% 0.68 to 9.00, P=0.16) for complications.
Conclusion: Flap?related complications are common intraoperative event during LASIK surgery performed by in?training ophthalmologists. Keratometries and surgeon’s first procedure represent a higher probability for flap related complications than some other biometric parameters of patient’s eye.

 
Keyword(s): LASER IN SITU KERATOMILEUSIS, INTRAOPERATIVE COMPLICATIONS, ACADEMIC TRAINING, REFRACTIVE SURGERY
 
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