| Brent Hanson - LASIKFRAUD.COM 2004-12-19, 7:11 pm |
| Preventing LASIK Buttonholes
Steep corneas and surface dryness increase patient risk
Balamurali K. Ambati, MD, and Alan N. Carlson, MD
LASIK is now widely performed, with an estimated 1.5 million procedures
performed last year.1 Flap complications have been reported in 5% to 8.7% of
cases.2 The buttonhole, occurring at a rate of 0.3% to 2.6%, is one of the
more serious flap abnormalities because it results in loss of BCVA.3-6
A buttonhole in the flap occurs when the microkeratome blade travels too
superficially and breaches the central epithelial/Bowman's complex. A
partial thickness buttonhole includes just the Bowman's layer; full
thickness buttonholes occur when the blade exits anteriorly through the
epithelium. A thin flap occurs when the keratome cuts within or anterior to
Bowman's layer. This manifests with a shiny reflex on the stromal surface
and can be recognized by a flap thickness of less than 60 µm (as the corneal
epithelium is approximately 50 µm and Bowman's approximately 12 µm).
The complete article is available at
www.reviewofrefractivesurgery.com/i...sp?page=6_6.htm
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