Outcome of second surgery in LASIK cases aborted due to flap complications

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Abstract
Purpose: To describe the technique and timing of second refractive surgery after aborted laser in situ keratomileusis (LASIK) due to intraoperative flap complication and determine the final visual outcome. Setting: Outpatient ambulatory laser vision correction centers. Methods: This retrospective noncomparative case series included 16 patients (16 eyes) who had a second refractive surgery after initial LASIK surgery was aborted because of a flap complication. Charts were reviewed with attention to initial preoperative data, intraoperative details of the aborted LASIK, postoperative examination, possible causes of the flap complication, timing and technique of second refractive surgery, and final visual outcome. Results: Causes of the aborted LASIK were identified in 13 of 16 eyes (81.2%) and included eye squeezing (5 eyes), loss of suction or machine failure (5 eyes), steep corneas (2 eyes), and learning curve of the surgeon (1 eye). The mean time until the second surgery was 135 days (range 49 to 372 days). Repeat flaps were created deeper and larger than the initially attempted flaps when possible. No patient had a final uncorrected visual acuity (UCVA) worse than 20/30 after the second surgery. Two eyes (12.5%) lost 1 line of best spectacle-corrected visual acuity. Conclusion: A planned delayed reoperation after sufficient corneal healing following an intraoperative flap complication can result in satisfactory recovery of UCVA.