Incidence of Flap Complications of Hansatome(R)in Laser in Situ Keratomileusis

PURPOSE: We investigated incidence of flap complications of Hansatome(R) (Bausch and Lomb) microkeratome in Laser In Situ Keratomileusis in Korean. METHODS: The author retrospectively investigated 889 eyes operated with Hansatome by 3 surgeons in Asan Medical Center. Sugeon I operated 227 eyes, Surgeon II 95 eyes and surgeon III 567 eyes. Complications were categorized into intraoperative and postoperative. We compared 567 eyes operated with Hansatome with 621 eyes opreated with Automated Corneal Shaper(R) (Bausch and Lomb Surgical, Chiron Division) by surgeon III. RESULTS: The incidence of flap complications of Hansatome in LASIK was 10 eyes (1.12%); 4 eyes (1.76%) by surgeon I, 3 eyes (3.16%) by surgeon II and 3 eyes (0.53%) by surgeon III. There was significant difference between the surgeons in incidence of complications (P< 0.05). The incidence of flap complications in Hansatome (0.53%) was significantly lower than in ACS keratome (3.0%) in surgeon III (P< 0.05). CONCLUSIONS: The incidence of flap complications in Hansatome was lower than in ACS keratome. There was significant decrease in experienced surgeon in terms of complications.

Central Retinal Artery Occlusion and Orbital Abscess following Dental Abscess

PURPOSE: Oral cavity or other head and neck inflammation may invade the orbit because paranasal sinuses are close to the orbital wall. The authors report a case of orbital abscess and central retinal artery occlusion followed by orbital invasion of the abscess after tooth extraction. METHODS: A 61-year old woman complained of persistent dental abscess and sudden visual loss for 2 weeks following tooth extraction. We performed a brain MRI (Magnetic Resonance Imaging) and an orbit CT (Computed Tomography) that revealed orbital cellulitis and orbital abscess. On fundus exam, cherry-red spot and retinal edema were noticed. RESULTS: Although ocular symptoms were improved with intravenous antibiotic therapy and surgical intervention, there was no recovery of visual acuity. CONCLUSIONS: Visual loss can be associated with delayed treatment in the case of orbital abscess. Therefore early diagnosis and proper treatment of orbital invasion following dental abscess is crucial for the recovery of vision.