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

Discussion in 'Glasses' started by visioncareindia.com, Oct 9, 2008.

  1. 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.
    visioncareindia.com, Oct 9, 2008
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