Femtosecond Laser Flap complication, Last word on Lasik iscaution,remove glasses by laser

complication Femtosecond Laser Flap Creation for LASIK

Sub- Epithelial Gas Breakthrough
There have been previous reports of these cavitation bubbles migrating
to the anterior chamber resulting in poor tracking during subsequent
excimer laser ablation.3,4 Vertical subepithelial gas breakthrough
during femtosecond laser flap creation is extremely rare and a Pub Med
search revealed no previous report of this complication. Vertical gas
breakthrough occurs between the dissection plane and the subepithelial
space resulting in escape of gas bubbles in to the subepithelial
space. The cause is unknown but a thin flap or a focal break in the
Bowman's membrane may contribute to this complication


The six researchers of the paper are medical scientists from the best
eye institutions -- L V Prasad Eye Institute, Hyderabad, Sankara
Nethra-laya, Chennai, Dr Rajendra Prasad Centre for Ophtha-lmic
Sciences, All India Institute of Medical Sciences, Cornea Service,
Wills Eye Hospital, Philadelphia, US.
From complications associated with the corneal cap removal to its
perforation, the researchers list several things that may go wrong.
For instance, the head of the microkeratome, or the instrument used
for performing the surgery, may not complete its full excursion across
the cornea resulting in an incomplete cut. Or it may cut the flap off
completely, resulting in a free cap.
While no Indian studies are available, a study of 1,019 eyes reported
in the American Journal of Ophthalmology, had shown such complications
in 109 eyes or a high 8.6 per cent of the patients.
A corneal perforation during the creation of a flap is a devastating
intra-operative complication, it says.
Among the other complications, an inflammatory reaction, known
commonly as Shifting Sands Syndrome, can occur through seemingly
innocous substances such as talc from gloves, oil, wax, metallic
fragments, and even particles from eye drapes, among others. A
progressive thinning of the cornea could be a potential, serious
late complication following Lasik, perhaps due to altered biomechanics
of this layer
of the eye.
In most cases, there is a decrease in tear secretion following the
surgery. Night vision problems and other optical aberrations may occur
in some cases. Under correction and overcorrection after myopic Lasik
is not uncommon, says the journal. Though rare, infection following
Lasik is a potentially vision-threatening complication. The incidence
is expected to be one in 5,000.