Folded in Half Flap Versus Reflected Flap During Conventional LASIK for Correction of Hyperopia

Sunday, April 19, 2015: 2:21 PM
Room 3 (San Diego Convention Center)
Waleed A. Ghobashy, MD, PhD
Mohamed E. Shahin, MD, PhD

To compare both folded into half (taco) LASIK flap and reflected upon LASIK flap regarding flap protection from accidental ablation, under surface debris, and visual recovery.

Prospective study, included 48 eyes of 24 patients were subjected to LASIK for hyperopia. Microkeratome created a 160-µ flap with superior hinge. For the right eye spatula was inserted under the middle of the flap, drag it that underside of upper half of the flap sticks to underside of the lower part of the flap in taco-shape then flayed on superior bulbar conjunctiva. For the left eye, the flap was reflected upon flayed on upper lid. After ablation, stromal bed was irrigated, and flap was repositioned. We evaluated flap and debris underneath with UCVA and manifest refraction for one month.

Laser ablation lasted 28.75 ± 4.8 seconds with total ablation zone (8.50 ± 0.49 mm), Six right eyes showed few laser burns on the inferior epithelial margin, healed by the first day. Six left eyes showed partial hinge ablation lasted 1 week.  Stromal Irrigation lasted 22 ± 2.4 seconds for right eyes and 27.5 ± 3.5 seconds for left eyes. By the 1st week, no debris was seen under the flap in any eye. Right eyes mean UCVA was 0.8 in the first postoperative day, 0.5 in left eyes, mean was 0.9 by 1st month.  No complications documented.

Folded into half LASIK flap (taco – flap) may offer superior protection of the flap and less needed irrigation time for the stromal bed, with faster visual recovery limited to the 1stmonth in comparison to conventional reflected upon LASIK flap in correction of hyperopia.