Lasik surgery is referred to as vision correction surgery or laser eye surgery. This type of surgery basically helps to correct myopia (near-sightedness), hypermetropia (far-sightedness), and astigmatism.
Lasik procedure includes adding a tiny hinged flap on the face of the cornea. During the operation, this is lowered to laser eye reshaping. Then the flap is interchanged for a real bandage. If the Lasik membrane is not properly produced, it may not stick appropriately to the bottom of the eye, resulting in blurred sight. Some Lasik flap complication issues include:
• Irregular astigmatism (unequally curved corneal surface).
• Epithelial in growth (cells from the outer layer of the cornea grow under the flap).
• Diffuse lamellar keratitis (inflammation under the Lasik flap).
• Keratectasia or keratoconus (bulging of the eye’s surface).
In most instances, important under correction or regression can be handled effectively after your surgeon confirmed a further laser vision correction.
The Purpose for a Second Surgery in Lasik cases aborted due to Flap Complications
The second Lasik surgery is basically conducted to correct the deviations caused post the first procedure and also to determine the process of second refractive surgery following aborted laser in situ Keratomileusis (LASIK) due to complication intra-operative flap, and the final visual outcome. Unfinished flaps are a major complication of LASIK surgery. If not accurately recognized and dealt with, the visual acuity can linger, the best corrected visual acuity (BCVA) suffered, diplopia worsened and vision endangered at night.
Method to manage such complications
If the surgery includes an incomplete cap, it must stop to determine prospective etiological statuses and assess the position of the scar. If the unfinished fold leads to a suction split, the physician must determine what triggered it. When the suspected etiology is not divided, the eye must be carefully examined for errors and the instrument evaluated in order to prevent future malfunctions.
The procedure can continue without any risks of further refractive post-operative complications if laser ablations can be determined on the surface of the stromal bed in a suitable ablation region as planned. If the hinge is beyond the visual axis, but the stromal bed is smaller than intended, re-trying to create the flap with an immediate second pass of the microkeratome or femtosecond laser is considered safe. When the hinge is in the visual axis, the flap must be substituted entirely and the process must be limited to another day.
In cases where a second immediate pass is not possible and the operation is delayed, the second action has two possibilities:
• Physical Examination – After the original flap has been permitted to cure, a second part can be tried using either microkeratome top or a femtosecond laser. There is no consensus as to how long the optimal recovery duration should last, but it is agreed that re-treatment should not be undertaken before three months. There are risks connected with either microkeratome or femtosecond cell trying a second therapy. The main danger is the fresh slit that intersects with the original slit, ending in stromal fragmentation and corneal tissue losing ability.
• Photorefractive Keratectomy or Laser Subepithelial Keratomileusis – this is the second alternative of ground removal through the unfinished flap by photorefractive keratectomy or spin Keratomileusis. These options reduce the risk of a second laser microkeratome or femtosecond and enable any corneal surface abnormalities to be treated simultaneously. Only 2–4 weeks after the first attempt should this procedure be performed.
The two most significant and efficient methods for preventing unfinished flap consist of ensuring a correctly working machine and ensuring a secure way for microkeratome or a femtosecond laser. The microkeratome cap should before any operation be thoroughly checked and washed and the entire unit should be checked before use. Proper draping will stop the route being obstructed by the clogs and chambers. Global lifting trying to follow suction activity can help clear the route, particularly in people with deep-seated eyes. Intraoperative tonometry can often be used to detect the danger of suction failure, to achieve appropriate IOP. The appropriate increase of intraocular pressure can also be confirmed through clinical indications such as eye dilatation and dimming sight.
Generally speaking, patients who face unfinished flap during Lasik have exceptional long-term vision results. Rare cohort studies have shown that visual results are no different from the cohort that has not experienced an incomplete flap, which has been treated promptly with a second pass. Incomplete flap problems are rarely sensory problems, including reduction of BCVA and night vision impairment. Two cases show the incidence of unfinished corneal ecstasies leading to unfinished flap, but this result is thought to be extremely uncommon.
A properly planned and scheduled late re-operation following enough corneal curing after an Intraoperative flap complication can lead to a satisfactory UCVA recovery.