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Visual rehabilitation after LASIK complication: flap amputation, topo-guided surgery, and phacoemulsification

Visual rehabilitation after LASIK complication: flap amputation, topo-guided surgery, and phacoemulsification

Frederico França Marques1,2; Daniel Filipe Oliveira Rabelo1; Daniela Meira Villano Marques1,2; Glauco Sérgio Avelino de Aquino1; Daniel Diniz da Gama1; Bernardo Kaplan Moscovici1,3

DOI: 10.5935/0004-2749.2023-0221

ABSTRACT

We present a case of a patient complaining of monocular diplopia due to a decentered ablation after LASIK. The patient underwent a wavefront-guided retreatment, which resulted in an epithelial ingrowth complication. Additionally, the patient developed cataract, with cataract surgery requiring reliable biometric measurements. Therefore, we opted for corneal treatment and corneal surface regularization. Although we attempted to lift the flap and wash the interface initially, the procedure proved unsuccessful, thereby necessitating immediate flap amputation. Once the corneal surface was regularized in the seventh postoperative month, transepithelial photorefractive keratectomy was successfully performed to homogenize the ocular surface, thereby significantly improving the patient's corrected visual acuity and resolving monocular diplopia. The surface and corneal curvature stabilized by the fifth month after the procedure. Phacoemulsification was then performed along with the implantation of a toric monofocal lens, which was selected using an appropriate formula, resulting in an excellent uncorrected visual acuity.

Keywords: Refractive surgical procedures; Surgical flap/surgery; Keratomileusis laser In situ/methods; Biometry; Corneal topography; Lasers, Excimer/adverse effects; Dipoplia/etiologia; Visual acuity; Humans; Case reports


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