Thin Flap Complications

Abstract

The poor-quality flaps like thin, irregular, or buttonhole flaps occur in 0.3–2.6 % of mechanical microkeratomes LASIK procedures. The incidence with the femtosecond laser seems lower. During the creation of the corneal flap using the femtosecond IntraLASIK procedure, the flap may be cut leaving a hole in the center or mid-periphery of the flap. It is important to use caution when lifting such a flap. Clinical concerns when dealing with poor-quality flaps include the potential for epithelial cells to infiltrate the stroma, causing epithelial ingrowth in the central axis. This may result in corneal scarring in the visual field, affecting visual acuity. In addition, invasive epithelial ingrowth can lead to more severe complications such as stromal melting.