Cargando…

Incidence, Risk, and Visual Outcomes after Repositioning of Acute Non-Traumatic Flap Dislocations Following Femtosecond-Assisted LASIK

Although the use of femtosecond lasers instead of mechanical devices has decreased the incidence of flap complications following laser-assisted in situ keratomileusis (LASIK), dislocations and striae still occur. Flap repositioning is an effective intervention to improve visual outcomes after acute...

Descripción completa

Detalles Bibliográficos
Autores principales: Moshirfar, Majid, West, David G., Miller, Chase M, West, William B., McCabe, Shannon E., Shmunes, Kathryn M., Baker, Preston A., Ronquillo, Yasmyne C., Hoopes, Phillip C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199895/
https://www.ncbi.nlm.nih.gov/pubmed/34204958
http://dx.doi.org/10.3390/jcm10112478
_version_ 1783707482828308480
author Moshirfar, Majid
West, David G.
Miller, Chase M
West, William B.
McCabe, Shannon E.
Shmunes, Kathryn M.
Baker, Preston A.
Ronquillo, Yasmyne C.
Hoopes, Phillip C.
author_facet Moshirfar, Majid
West, David G.
Miller, Chase M
West, William B.
McCabe, Shannon E.
Shmunes, Kathryn M.
Baker, Preston A.
Ronquillo, Yasmyne C.
Hoopes, Phillip C.
author_sort Moshirfar, Majid
collection PubMed
description Although the use of femtosecond lasers instead of mechanical devices has decreased the incidence of flap complications following laser-assisted in situ keratomileusis (LASIK), dislocations and striae still occur. Flap repositioning is an effective intervention to improve visual outcomes after acute flap complications in both microkeratome-assisted and femtosecond-assisted LASIK. This retrospective case series included patients undergoing flap repositioning secondary to acute flap dislocation and/or visually significant striae within the first two weeks following femtosecond LASIK (FS-LASIK) from 2015 to 2020 at a single institution. Preoperative, intraoperative, and postoperative de-identified data were analyzed for incidence, risk factors, and visual acuity outcomes. The incidence of flap repositioning was 0.35% in 21,536 eyes (n = 70). Indications for repositioning included acute flap dislocation (35.7%) and visually significant striae (64.3%). High myopia (OR = 3.04, p = 0.001) and patient age over 50 years (OR = 3.69, p = 0.001) were the strongest risk factors for these complications. Prior to flap repositioning, uncorrected distance visual acuity (UDVA) of 20/20 or better and 20/40 or better occurred in 19% and 57% of eyes, respectively. After repositioning, a final UDVA of 20/20 or better and 20/40 or better occurred in 78% and 98% of eyes, respectively. After repositioning, one line of UDVA was lost in two eyes (2.8%) and two lines were lost in one eye (1.4%). Risk factors for acute flap dislocation included high myopia and age over 50 years. Flap repositioning was effective in salvaging visual outcomes.
format Online
Article
Text
id pubmed-8199895
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-81998952021-06-14 Incidence, Risk, and Visual Outcomes after Repositioning of Acute Non-Traumatic Flap Dislocations Following Femtosecond-Assisted LASIK Moshirfar, Majid West, David G. Miller, Chase M West, William B. McCabe, Shannon E. Shmunes, Kathryn M. Baker, Preston A. Ronquillo, Yasmyne C. Hoopes, Phillip C. J Clin Med Article Although the use of femtosecond lasers instead of mechanical devices has decreased the incidence of flap complications following laser-assisted in situ keratomileusis (LASIK), dislocations and striae still occur. Flap repositioning is an effective intervention to improve visual outcomes after acute flap complications in both microkeratome-assisted and femtosecond-assisted LASIK. This retrospective case series included patients undergoing flap repositioning secondary to acute flap dislocation and/or visually significant striae within the first two weeks following femtosecond LASIK (FS-LASIK) from 2015 to 2020 at a single institution. Preoperative, intraoperative, and postoperative de-identified data were analyzed for incidence, risk factors, and visual acuity outcomes. The incidence of flap repositioning was 0.35% in 21,536 eyes (n = 70). Indications for repositioning included acute flap dislocation (35.7%) and visually significant striae (64.3%). High myopia (OR = 3.04, p = 0.001) and patient age over 50 years (OR = 3.69, p = 0.001) were the strongest risk factors for these complications. Prior to flap repositioning, uncorrected distance visual acuity (UDVA) of 20/20 or better and 20/40 or better occurred in 19% and 57% of eyes, respectively. After repositioning, a final UDVA of 20/20 or better and 20/40 or better occurred in 78% and 98% of eyes, respectively. After repositioning, one line of UDVA was lost in two eyes (2.8%) and two lines were lost in one eye (1.4%). Risk factors for acute flap dislocation included high myopia and age over 50 years. Flap repositioning was effective in salvaging visual outcomes. MDPI 2021-06-03 /pmc/articles/PMC8199895/ /pubmed/34204958 http://dx.doi.org/10.3390/jcm10112478 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Moshirfar, Majid
West, David G.
Miller, Chase M
West, William B.
McCabe, Shannon E.
Shmunes, Kathryn M.
Baker, Preston A.
Ronquillo, Yasmyne C.
Hoopes, Phillip C.
Incidence, Risk, and Visual Outcomes after Repositioning of Acute Non-Traumatic Flap Dislocations Following Femtosecond-Assisted LASIK
title Incidence, Risk, and Visual Outcomes after Repositioning of Acute Non-Traumatic Flap Dislocations Following Femtosecond-Assisted LASIK
title_full Incidence, Risk, and Visual Outcomes after Repositioning of Acute Non-Traumatic Flap Dislocations Following Femtosecond-Assisted LASIK
title_fullStr Incidence, Risk, and Visual Outcomes after Repositioning of Acute Non-Traumatic Flap Dislocations Following Femtosecond-Assisted LASIK
title_full_unstemmed Incidence, Risk, and Visual Outcomes after Repositioning of Acute Non-Traumatic Flap Dislocations Following Femtosecond-Assisted LASIK
title_short Incidence, Risk, and Visual Outcomes after Repositioning of Acute Non-Traumatic Flap Dislocations Following Femtosecond-Assisted LASIK
title_sort incidence, risk, and visual outcomes after repositioning of acute non-traumatic flap dislocations following femtosecond-assisted lasik
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199895/
https://www.ncbi.nlm.nih.gov/pubmed/34204958
http://dx.doi.org/10.3390/jcm10112478
work_keys_str_mv AT moshirfarmajid incidenceriskandvisualoutcomesafterrepositioningofacutenontraumaticflapdislocationsfollowingfemtosecondassistedlasik
AT westdavidg incidenceriskandvisualoutcomesafterrepositioningofacutenontraumaticflapdislocationsfollowingfemtosecondassistedlasik
AT millerchasem incidenceriskandvisualoutcomesafterrepositioningofacutenontraumaticflapdislocationsfollowingfemtosecondassistedlasik
AT westwilliamb incidenceriskandvisualoutcomesafterrepositioningofacutenontraumaticflapdislocationsfollowingfemtosecondassistedlasik
AT mccabeshannone incidenceriskandvisualoutcomesafterrepositioningofacutenontraumaticflapdislocationsfollowingfemtosecondassistedlasik
AT shmuneskathrynm incidenceriskandvisualoutcomesafterrepositioningofacutenontraumaticflapdislocationsfollowingfemtosecondassistedlasik
AT bakerprestona incidenceriskandvisualoutcomesafterrepositioningofacutenontraumaticflapdislocationsfollowingfemtosecondassistedlasik
AT ronquilloyasmynec incidenceriskandvisualoutcomesafterrepositioningofacutenontraumaticflapdislocationsfollowingfemtosecondassistedlasik
AT hoopesphillipc incidenceriskandvisualoutcomesafterrepositioningofacutenontraumaticflapdislocationsfollowingfemtosecondassistedlasik