Purpose: To study the role of photorefractive keratectomy (PRK) in the management of laser in situ keratomileusis (LASIK) flap complications.
Methods: A retrospective analysis was performed of seven patients (14 eyes) who had bilateral, simultaneous LASIK (single surgeon [TGA], Summit Apex Plus laser, Hansatome microkeratome in six patients [12 eyes], Automated Corneal Shaper keratome in one patient [two eyes]). One eye of each patient received PRK for a flap complication. The seven patients (four women, three men) had a mean age of 39.2 years (range, 22 to 64 yr). The uncomplicated LASIK eyes had moderate to high myopia (-2.25 to -8.75 D) and the eyes with LASIK flap complications had mild to moderate myopia (-1.50 to -5.75 D). Immediate transepithelial PRK was performed in all eyes after repositioning the defective flap.
Results: All seven patients had excellent visual outcome at 6 months follow-up; one patient required an enhancement (astigmatic keratotomy). Six of the seven LASIK eyes had best spectacle-corrected visual acuity of 20/20 or better and one LASIK eye had 20/25. In the transepithelial PRK eyes, six of the seven eyes had best spectacle-corrected visual acuity of 20/20 or better and one eye had 20/30.
Conclusions: Immediate transepithelial PRK treatment of irregular and incomplete LASIK flaps at the time of surgery is an excellent therapeutic option to delayed surgical treatment.