Comparison of Complications of the Corneal Flap following LASIK by Three Different Manual Microkeratomes

PURPOSE: To compare and analyze intraoperative and postoperative complications of corneal flap in the LASIK procedures using different types of manual microkeratomes (MLK, LSK, disposable Barron). METHODS: Eight hundred sixty-two eyes were retrospectively evaluated to study the effects of 3 different microkeratomes on the frequency of complications, managements, and postoperative best visual acuity. The eyes were grouped according to the microkeratomes used in making corenal flap: Group 1 (334 eyes) treated with MLK(SCMD, USA); Group 2 (256 eyes), LSK(Moria, France); Group 3 (272 eyes), disposable Barron(Katena, USA). RESULTS: Mean follow-up period was 6.3 months and mean age was 29.2 years (range 20 39). Complications of corneal flap were observed in 74(7.9%) of 862 eyes. Intraoperative flap complications occurred in 15 eyes (4.5%), 6 eyes (2.4%) and 3 eyes (1.2%) in each group, respectively. The postoperative flap complications were observed in 24 eyes (7.2%), 17 eyes (6.7%) and 9 eyes (3.3%) in each group. The postoperative best corrected visual acuity decreased by 2 lines or more in 2 eyes (0.6%), 1 eye (0.4%) and none (0%) of each group. CONCLUSIONS: The incidence of corneal flap-related complications by manual microkeratomes was relatively low. Disposable Barron microkeratome showed the lowest complication rate in our series. It also has an advantage of easy maneuverability, and reproducibility (equal size and thickness of corneal flap).

Clinical Results of Primary Posterior Continuous Curvilinear Capsulorhexis

PURPOSE: To evaluate the outcome of posterior continuous curvilinear capsulorhexis (PCCC) performed simultaneously with cataract surgery to inhibit after-cataract. METHODS: Among patients who underwent phacoemulsification and posterior chamber intraocular lens implantation from December 1999 through December 2001, we had followed on 94 eyes of 80 patients who underwent PCCC intraoperatively and 100 eyes in 92 patients without PCCC as control group. Both groups were divided into 4 categories: nonproliferative diabetic retinopathy(NPDR); uveitis; below 60 years without ocular and systemic disease; over 60 years without ocular and systemic disease. Preoperative and postoperative visual acuity and complications were analyzed from 6 months to 12 months. RESULTS: There was statistically no difference in the best corrected visual acuity at 6 months between PCCC and control group in all categories. Transient increase in the intraocular pressure was noted in 5 eyes (5%) of PCCC group and 3 eyes (3%) in control group. Vitreous prolapse into anterior chamber was found in 2 eyes (2%) of PCCC group. Cystoid macular edema was found in only 1 eye (1%) in NPDR patients of PCCC group. Progression of diabetic retinopathy was found in 1 eye (5.6%) and 3 eyes (12.5%) in each group respectively. There was no statistically significant difference in progression of diabetic retinopathy after surgery between the two groups. CONCLUSIONS: Primary PCCC is a safe procedure to perform in patient who has a predisposition to after-cataract.