Risk factors and retreatment results of intraoperative flap complications in LASIK

Purpose: To evaluate the incidence, type, and risk factors of intraoperative complications leading to abandonment of laser in situ keratomileusis (LASIK), and to compare the safety and efficacy of retreated LASIK with uncomplicated primary LASIK. Setting: Refractive surgery centers in Tokyo, Yokohama, Nagoya, Osaka, and Fukuoka, Japan. Methods: A total of 3751 eyes of 2033 patients who were followed for 6 months after primary LASIK, of which 15 eyes were retreated after intraoperative flap complications, were reviewed. In most of the cases, retreatments were performed by recutting a new flap. Results: Intraoperative flap complications occurred in 25 eyes, of which 15 eyes had retreatment at a later date. The overall incidence of complications was independent of the surgeons' experience, although incomplete flaps, in particular, occurred at a higher rate in the hands of inexperienced surgeons. No patient profile was detected as a risk factor for intraoperative flap complications. No flap-related complications occurred at retreatment. Refractive and visual outcomes were comparable to those in the uncomplicated cases within 6 months postoperatively. Conclusions: Retreatment after microkeratome flap complications by recutting the cornea is safe and effective.