Microkeratome Complications

There are three primary flap-related complications:

(NOTE: THE FOLLOWING DO NOT APPLY TO INTRALASIK, ONLY MICROKERATOME LASIK)


Free Cap: When LASIK was originated, the flap created was purposely detached completely from the cornea and laid back into place after the laser. Nowadays the flap is left with an attachment on one side, called a hinge, so it cannot be lost or rotated out of place when it is laid back down. In less than 1 out of 200 cases the hinge is not left at the edge of the flap if the microkeratome makes too complete of a pass. Although this technically qualifies as a complication, it is not an issue in terms of healing or visual outcome since alignment markings are made on the cornea prior to surgery.

Incomplete Pass : This complication is more historical in nature than actual. Early models of microkeratomes that were gear-driven could get jammed from debris or an eyelash, which could result in a partial flap. The partial flap was laid down and allowed to heal, and could be re-cut in three months. This only occurred in 1 out of 500 cases, and was more of an inconvenience than a complication. Today's microkeratomes are designed in such a way so as not to carry that risk.

   

Thin Cap: A flap that is cut too thin can be more difficult to smooth out when it is laid back down, resulting in tiny wrinkles that can interfere with clarity of vision. Again, this is an inconvenience more than anything, and it occurs in about 1out of 1000 cases.