BACKGROUND: A case presentation of a patient that underwent a LASIK enhancement procedure with a microkeratome malfunction that resulted in a poor post-operative outcome
CASE REPORT(S). A 44 year-old male presented to our clinic July 2001 with a history of bilateral LASIK in 1998 and an enhancement procedure on his left eye in March of 1999. While creating a new flap, the microkeratome malfunctioned and created a full-thickness corneal laceration with iris prolapse and expulsion of the crystalline lens. He was then urgently operated upon to secure the cornea. His entering acuities were 20/20 UCVA OD and 20/40 while wearing a SCL with a painted iris OS. The refraction showed an errror of -0.75+0.50x085 OD with 20/20 VA and +9.50+2.25x070 OS with 20/15 VA. Biomicroscopy of the left eye showed corneal vessels, cicatricial opacification, interrupted 10-0 sutures, and evidence of the previous penetrating corneal injury. The iris was visible in the far periphery near the angle with adherence to the cornea nasally. The central posterior capsule was absent with some visible adherence to the cornea and iris. The IOPs, confrontations and posterior exam were unremarkable. He recently underwent an anterior vitrectomy, aniridia IOL implantation, and an iris repair. He is currently under post-operative follow up.
CONCLUSIONS. LASIK is still one of the most popular and marketable surgical methods to correct myopia despite some of the significantly undesirable visual outcomes of the procedure. The public needs to understand the risks of this elective procedure including the more common issues of DLK, epithelial ingrowth, and flap striae, to the more serious issues of infection, flap dehiscence and corneal laceration.