Vertical Gas Breakthrough During Femtosecond Laser Flap Creation for Laser In Situ Keratomileusis in an Eye with Previous Microkeratome Flap
Using the femtosecond laser to create the corneal flap during laser in situ keratomileusis (LASIK) has many advantages in predictability and reliability over the microkeratome. However, each surgical procedure may have complications. One of them is vertical gas breakthrough as a result of escaping gas bubbles from the dissection plane into the subepithelial space. In this case, the cause would be related to a previous thin flap or a focal break in the Bowman’s layer. The refractive surgeon should be aware that this complication can be associated with epithelial down growth, corneal scar, and microstriae. A decrease of best corrected visual acuity (BCVA) may occur if the pupillary area is involved.
KeywordsFemtosecond Laser Well Correct Visual Acuity Corneal Scar Corneal Topography Uncorrected Visual Acuity
A vertical bubble between the previous flap and the epithelium was clearly visible at the superior margin of the flap. The flap was gently lifted without creating a buttonhole. At the end, the standard excimer ablation procedure was performed (MP4 5937 kb)