Intraoperative and early postoperative complications of laser in situ keratomileusis in Yemen

OBJECTIVE: To determine the intraoperative and early postoperative complications and visual outcome of laser in situ keratomileusis (LASIK) surgery for the correction of myopia.

METHODS: The first 2000 consecutive myopic LASIK eyes operated at the Department of Refractive Surgery, Yemen Magrabi Hospital, Sana'a, Yemen from June 2005 to October 2006 were the study group. This is a retrospective observational noncomparative clinical study. The preoperative and postoperative spherical equivalent, best-corrected visual acuity, and corneal status was recorded. The intraoperative and early postoperative complications were reviewed.

RESULTS: There were 15 (0.8%) intraoperative microkeratome-related flap complications recorded namely, buttonhole (5), incomplete cut (3), thin flap (3), epithelial defect (3) and eccentric flap (1). There were 4 (0.2%) non-keratome related surgical events of inability to obtain sufficient suction. There were 46 (2.3%) first-day postoperative complications. Nine eyes required repositioning of the flap for macro-striae (5), or displaced flap (4). Four needed washing under the flap for severe deep lamellar keratitis (2), and gauze debris under the flap (2). Laser enhancement was carried out in 28 eyes (1.4%), and uncorrected visual acuity of 20/40 or better was attained in 96.9% of treated eyes. Twenty-four eyes (1.3%) lost more than 2 lines of best-corrected vision.

CONCLUSION: The LASIK is a safe and effective procedure for the correction of myopia. A small number of patients may suffer complications, most of which are not serious, and rarely lead to visual loss of more than 2 Snellen lines.