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Transected Lamellar Cut Following Second Pass with a Femtosecond Laser after Incomplete Flap Construction during Laser In Situ Keratomileusis

Anthony Liu and Edward E. Manche

Background: The majority of complications of Laser in Situ Keratomileusis leading to vision loss are related to the corneal flap. Uses of the femtosecond laser for flap construction has been shown have improved safety and predictability when compared to mechanical keratome use. We report a case of irregular astigmatism following second pass with a femtosecond laser performed due to incomplete flap construction.<> Methods: Single observational case report.
Results: Examination revealed a horizontal linear opacified stromal scar likely representing a discontinuity of the deeper second flap plane with transection into the original flap plane. This complication caused a loss of six lines of best corrected visual acuity.
Conclusion: This case demonstrates that complications resulting in persistent significant visual loss are possible with use of the femtosecond laser for a second pass following incomplete flap construction.