Candesartan and carvedilol for primary prevention of subclinical cardiotoxicity in breast cancer patients without a cardiovascular risk treated with doxorubicin.

BACKGROUND: There is no proven primary preventive strategy for doxorubicin-induced subclinical cardiotoxicity (DISC), especially among patients without a cardiovascular (CV) risk. We investigated the primary preventive effect on DISC of the concomitant use of angiotensin receptor blockers (ARBs) or beta-blockers (BBs), especially among breast cancer patients without a CV risk. METHODS: A total of 385 patients who were scheduled for doxorubicin chemotherapy were screened. Among them, 195 patients of the study populations were included and were randomly divided into two groups [candesartan 4 mg q.d. vs. carvedilol 3.125 mg q.d.] and patients who were unwilling to take one of the medications were evaluated as controls. The primary outcomes were the incidence of early DISC (DISC developing within 6 months after chemotherapy), and late DISC (DISC developing only at least 12 months after chemotherapy). RESULT: Compared with the control group (8 out of 43 patients (18.6%)), only the candesartan group (4 out of 82 patients (4.9%)) showed a significantly lower incidence of early DISC (p = 0.022). Compared with the control group, the candesartan group demonstrated a significantly reduced decrease in left ventricular ejection fraction (LVEF) throughout the study period [-1.0% vs. -3.00 (p < 0.001) at the first follow-up, -1.10% vs. -3.40(p = 0.009) at the second follow-up]. CONCLUSIONS: Among breast cancer patients without a CV risk treated with doxorubicin-containing chemotherapy, subclinical cardiotoxicity is prevalent and concomitant administration of low-dose candesartan might be effective to prevent an early decrease in LVEF. Further large-scale, randomized controlled trials will be needed to confirm our findings.

Correlation between obesity and clinicopathological factors in patients with papillary thyroid cancer.

PURPOSE: Epidemiological studies have shown that obesity is associated with an increased risk of thyroid cancer. However, the exact nature of the relationship, especially with respect to the behavior of the cancer, remains uncertain. The objective of this study was to evaluate the correlation between the body mass index (BMI) and clinicopathological features of thyroid cancer patients. METHODS: From January 2009 to April 2010, 716 consecutive patients (602 females and 114 males; mean age 47.02 ± 11.73 years) with papillary thyroid cancer (PTC) were analyzed retrospectively. Patients were divided into two subgroups according to age (<45 years, ≥45 years). The BMI groupings were based on standardized categories set by the World Health Organization. The relationships between the BMI and these parameters were assessed. RESULTS: A non-overweight BMI was associated with a younger age and female gender. Tumor multiplicity was related to a higher BMI. In an age-related subgroup analysis, a higher BMI was correlated with more lymph node involvement (p = 0.004), lymphatic invasion (p = 0.003) and tumor multiplicity (p = 0.008) in patients ≥45 years of age. The absence of an association between the BMI and T stage, nodal status, vascular invasion, lymphatic invasion, and extrathyroidal extension was noted in a statistical analysis. In the subgroup of patients <45 years of age, no positive associations were observed between the BMI and any parameters other than age and sex. CONCLUSIONS: In PTC patients ≥45 years of age, a higher BMI was associated with more aggressive tumor features, such as lymph node metastasis, lymphatic invasion, and tumor multiplicity.

The potential role of estrogen receptor ß2 in breast cancer.

Endocrine therapy is provided to all patients with estrogen receptor (ER)-positive breast cancer, but only a subset of them derives clinical benefit. The discovery of ERß and its five isoforms added another layer of complexity in the regulation of estrogen activity in breast cancer cells. Two large retrospective studies showed conflicting results with regard to the prognostic value of the different ERß isoforms in patients treated with tamoxifen in an adjuvant setting. This study tested the hypothesis that ERß1 and, or ERß2 are correlated with clinical outcome. We identified patients with breast cancer who had undergone surgery at Bucheon St. Mary's Hospital, the Catholic University of Korea, between January 2004 and March 2006. We evaluated 101 consecutive cases for ERß1 and ERß2 expression using immunohistochemical staining and obtained other clinicopathology by reviewing medical records. ERß1 was expressed in 81.2% (79 of 97) and ERß2 was expressed in 50.5% (51 of 101) of primary breast cancer tissues. Disease-free survival (DFS) and overall survival (OS) of patients with cancers expressing ERß2 was significantly worse. Moreover, in subgroup analysis according to the tamoxifen treatment, ERß2 expression was significantly associated with shorter DFS of tamoxifen-treated patients. This study indicates that breast cancer with ERß2 expression was associated with worse DFS and OS, especially in tamoxifen treated patients. Our results suggest a role for ERß2 as an independent prognostic marker and might serve as a new therapeutic target.

Mammographic artifacts on full-field digital mammography.

This study investigates the incidence of full-field digital mammographic (FFDM) artifacts with three systems at two institutions and compares the artifacts between two detector types and two grid types. A total of 4,440 direct and 4,142 indirect FFDM images were reviewed by two radiologists, and artifacts were classified as patient related, hardware related, and software processing. The overall incidence of FFDM artifacts was 3.4% (292/8,582). Patient related artifacts (motion artifacts and skin line artifacts) were the most commonly detected types (1.7%). Underexposure among hardware related artifacts and high-density artifacts among software processing artifacts also were common (0.7 and 0.5%, respectively). These artifacts, specific to digital mammography, were more common with the direct detector type and the crossed air grid type than with the indirect type and linear grid type (p < 0.05). The most common mammographic artifacts on FFDM were patient related, which might be controlled by the instruction of a patient and technologist. Underexposure and high-density artifacts were more common with direct detector and crossed air type of grid.

Hydrogen peroxide-responsive copolyoxalate nanoparticles for detection and therapy of ischemia-reperfusion injury.

The main culprit in the pathogenesis of ischemia/reperfusion (I/R) injury is the generation of high level of hydrogen peroxide (H2O2). In this study, we report a novel diagnostic and therapeutic strategy for I/R injury based on H2O2-activatable copolyoxalate nanoparticles using a murine model of hind limb I/R injury. The nanoparticles are composed of hydroxybenzyl alcohol (HBA)-incorporating copolyoxalate (HPOX) that, in the presence of H2O2, degrades completely into three known and safe compounds, cyclohexanedimethanol, HBA and CO2. HPOX effectively scavenges H2O2 in a dose-dependent manner and hydrolyzes to release HBA which exerts intrinsic antioxidant and anti-inflammatory activities both in vitro and in vivo models of hind limb I/R. HPOX nanoparticles loaded with fluorophore effectively and robustly image H2O2 generated in hind limb I/R injury, demonstrating their potential for bioimaging of H2O2-associated diseases. Furthermore, HPOX nanoparticles loaded with anti-apoptotic drug effectively release the drug payload after I/R injury, exhibiting their effectiveness for a targeted drug delivery system for I/R injury. We anticipate that multifunctional HPOX nanoparticles have great potential as H2O2 imaging agents, therapeutics and drug delivery systems for H2O2-associated diseases.

Breast cancer after kidney transplantation: a single institution review.

BACKGROUND: Improvements in immunosuppression have resulted in long life expectancy of kidney transplants. Unfortunately, the incidence of post-transplant malignancy (PTM) is increasing. The aim of this study was to evaluate the nature and stage-specific prognosis of post-transplant breast cancer (PTBC) compared with breast cancer in the general population, and to suggest optimal treatment strategies. METHODS: A database of 2,139 consecutive kidney transplant patients was reviewed;11 of the patients developed breast cancer. These 11 PTBC cases underwent operations between 1999 and 2011. Next, 2,554 breast cancer patients treated in the same period were reviewed. Kaplan-Meier curves and the log-rank test were used to assess stage-specific survival of breast cancer in our hospital. RESULTS: In total, 142 cases experienced post-transplant malignancy (PTM; 6.6%) and 11 (0.5%) developed PTBC. No one required an adjusted dose of immunosuppressive agent. Two stage III patients died. For all breast cancer patients, 5-year survival by stage was 97.7% for stage I, 92.9% for stage II, 78.6% for stage III, and 49.9% for stage IV. The 5-year survival for expected stage III-specific survival was 66.7% and no significant statistical difference was seen compared to that of the total breast cancer patients (P = 0.213). CONCLUSIONS: The prognosis of PTBC was comparable to that of the general population. These results suggest that the use of immunosuppressants per se does not adversely affect breast cancer.

Biodegradable polyoxalate and copolyoxalate particles for drug-delivery applications.

Polyoxalate and copolyoxalate were developed in the 1970s and have been used for biomedical applications such as suture coating purposes, owing to their biocompatibility and biodegradability. They are known to degrade into diols and oxalic acid, which are considered biocompatible. One of the advantages of oxalate-based polymer is the ease of control of physicochemical properties, such as biodegradability, crystallinity and mechanical strength. The composition and hydrophobicity of diols greatly influenced their hydrolytic stability and mechanical properties. Oxalate-based polymers have faster hydrolytic-degradation kinetics than the commercial biodegradable polymers, poly(lactide-co-glycolide) and poly(caprolactone). Recently, our group has developed fully biodegradable polymer drug carriers based on oxalate-based polymers that are composed of various diols. The hydrophobicity of the oxalate-based polymers allowed them to be formulated into nano- or micro-particles, which are suitable for targeting macrophages in inflammatory diseases. The nano- or micro-particles exhibited excellent cytotoxicity profiles and fast drug-release kinetics, suggesting great potential as drug-delivery systems for the treatment of acute inflammatory diseases. In this article, we discuss the synthesis and physicochemical properties of oxalate-based polymers which can be used as a drug-delivery vehicle for the treatment of inflammatory diseases.

Lateral lymph node metastasis in papillary thyroid carcinoma: results of therapeutic lymph node dissection.

BACKGROUND: Cervical lymph node metastases are quite common in papillary thyroid cancer (PTC) and they usually spread in a contiguous fashion. However, "skip metastasis," defined as lateral lymph node metastasis without central lymph node metastasis, also occurs in patients with PTC. There is little information regarding skip metastasis in papillary thyroid microcarcinoma (PTMC). The goal of this study was to determine the prevalence and associated clinical and imaging features of skip metastasis in PTMC. METHODS: We performed a retrospective study of 245 patients with PTMC who underwent either thyroidectomy and central lymph node dissection or thyroidectomy, central lymph node dissection, and lateral lymph node dissection if preoperative ultrasonography or computed tomography suggested lateral node metastasis. Clinicopathologic results were reviewed, and the patterns of cervical lymph node metastasis were analyzed. RESULTS: Cervical lymph node metastases were present in 26.5% of cases. The frequency of lymph node metastases was 21.8% in the group that only had thyroidectomy and central lymph node dissection and 51.3% in the group that had thyroidectomy, central lymph node dissection, and lateral lymph node dissection. Younger age, larger tumor size, multiplicity, bilaterality, encapsulation, extrathyroid extension, and lymphatic invasion were associated with metastasis to nodes in the central or lateral compartment. Lateral lymph node dissection was performed in 15.9% of patients. Skip metastasis was observed in 7.7% of the cases in which combined central and lateral node dissection was performed. No features of the primary thyroid tumor could be associated with the development of skip metastasis. CONCLUSIONS: Skip metastases occur in a minority of patients with PTMC. We recommend, therefore, that preoperative studies in patients suspected of having PTMC focus not only on nodes in the central compartment but also lateral cervical nodes since the information obtained would guide the extent of surgery.

National monitoring of PCDD/DFs in environmental media around incinerators in Korea.

To examine the levels of PCDD/DFs pollution in environmental samples in the vicinity of various incinerators, the levels of PCDD/DFs in air and soil samples collected near 17 incinerators and stack emission gases were investigated between 2003 and 2006. A total of 434 soil, 28 stack emission gas, and 38 air samples were analyzed for their PCDD/DFs concentrations. The PCDD/DFs concentrations in the flue gas samples ranged from 0.02 to 16.41 ng I-TEQ/Sm(3), with an arithmetical mean value of 3.13 ng I-TEQ/Sm(3). The PCDD/DFs concentrations in the air samples ranged from 0.032 to 0.965 pg I-TEQ/Sm(3). The soil samples contained between N.D. and 153.23 pg I-TEQ/g-dry, with an average of 7.36 pg I-TEQ/g-dry. These levels were generally consistent with or lower than many previous studies. The average PCDD/DFs levels in the soil samples decrease with increasing distance from the incinerator. From the PCDD/DFs level gradient from each plant, a distance of 500 m is suggested as being under the influence of an incinerator.

Concentration and congener patterns of polychlorinated biphenyls in industrial and municipal waste incinerator flue gas, Korea.

In the present study, individual PCB congeners were determined in the flue gases of 10 industrial and 5 municipal solid waste incinerators using HRGC/HRMS. The total PCBs concentration of all congeners (168 tetra to deca-chlorinated congeners) ranged from 26 to 343 ng/Nm(3), and from 36 to 1095 ng/Nm(3) in industrial waste incinerators (IWI) and municipal solid waste incinerators (MSWI), respectively. The total TEQ concentrations of PCBs, calculated using WHO-TEF values, varied from 0.001 to 0.55 ng-TEQ/Nm(3) and from 0.001 to 8.29 ng-TEQ/Nm(3) in the industrial waste incinerators and municipal solid waste incinerators, respectively. In all samples, the contribution of PCB 126 to total TEQ of PCBs was higher than 87%. The homologue pattern of PCBs in the incinerator flue gas samples was generally dominated by tetra- and penta-CBs. The distribution of other homologues was less than 15% in most of the incinerators. The fraction of co-PCBs against to total PCBs ranged from 1% to 19% and from 2% to 31% in IWI and MSWI flue gas samples. Results of the present study reveal that the presence of non-ortho PCB congeners in the flue gas originated form the combustion process.

A modified iris repair technique and capsular tension ring insertion in a patient with coloboma with cataracts.

PURPOSE: We describe our successful experience using a capsular tension ring (CTR) and iris repair during cataract surgery in a patient with bilateral coloboma. METHODS: A 67-year-old woman had no history of trauma, but had zonular deficiency and inferonasal iris defects in both eyes. An extracapsular cataract extraction and intraocular lens (IOL) scleral fixation was performed in the left eye. A CTR was implanted in the right eye through a sclerocorneal incision. After the IOL was placed centrally in the capsular bag, two paracenteses were made at the limbus (5 o'clock and 7 o'clock). A long, straight needle was passed through the 7 o'clock paracentesis site into a angled, blunt tipped 27 gauge needle inserted from the 5 o'clock paracentesis. The two needles were pulled out at 5 o'clock. After inserting the long needle into the blunt tipped needle at 7 o'clock, both were passed back through the 7 o'clock paracentesis site. The needles were pulled out again at the 5 o'clock paracentesis site tied. Equal tension was used to tie both sides. RESULTS: Visual acuity improved to 20/20 in the right eye. CONCLUSIONS: Both capsular tension ring implantation and iris repair was successfully performed at the time of cataract surgery in a coloboma patient, which resulted in improvements in visual function and cosmesis.

The effect of simulation on recurrence after breast-conserving surgery and radiotherapy: preliminary results.

PURPOSE: To evaluate the effect of the simulation method on recurrence among the patients who received radiotherapy after breast-conserving surgery (BCS) for early breast carcinoma. MATERIALS AND METHODS: Between 1995 and 2000, 70 patients with stage I-II breast carcinoma underwent breast-conserving surgery and adjuvant radiotherapy. Twenty nine patients (41.4%) were simulated with the 2D contour-based method (September 1995 to August 1997) and 41 patients (58.6%) were simulated with the 3D CT-based method (September 1997 to February 2000). To analyze the effect of the simulation method, the patient and treatment characteristics were compared. RESULTS: The characteristics were similar for the patients between the 2D contour-based simulation group and the 3D CT-based simulation group. During a median follow-up period of 75 months, 4 (13.8%) of 29 patients who were treated with 2D simulation and 1 (2.4%) of 41 patients who were treated with 3D simulation group developed treatment failure. The five-year survival rates were 89.2% and 95.1% between the 2D and 3D simulation groups (p=0.196). The five-year disease free survival (DFS) rates were 86.2% and 97.5% between the 2D and 3D simulation groups (p=0.0636). On univariate analysis, age > 40 (p= 0.0226) and the number of dissected axillary lymph node >or= 10 (p=0.0435) were independent predictors of improved 5-year DFS. CONCLUSIONS: Although our data showed marginal significance for the DFS between the two groups, it is insufficient, due to the small number of patients in our study, to prove whether 3D CT-based simulation might improve the DFS and reduce the risk of recurrence when compared with 2D contour-based simulation. Further study is needed with a larger group of patients.

Clinical experience of patients with ductal carcinoma in situ of the breast treated with breast-conserving surgery plus radiotherapy: a preliminary report.

PURPOSE: Breast-conserving therapy (BCT) is a practical alternative to mastectomy for treating ductal carcinoma in situ (DCIS). We reviewed our experience for treating patients with DCIS of the breast to evaluate the outcome after performing breast-conserving surgery plus radiotherapy (BCS-RT). MATERIALS AND METHODS: Between January 1983 and December 2002, 25 patients with clinically or mammographically detected DCIS were treated by BCS-RT. One patient was diagnosed with bilateral DCIS. Thirteen cases (50%) had symptomatic lesions at presentation. All 26 cases of 25 patients underwent BCS such as lumpectomy, partial mastectomy or quadrantectomy. All of them received whole breast irradiation to a median dose of 50.4 Gy. Twenty-four cases (92.3%) received a boost to the tumor bed for a median total dose of 59.4 Gy. The median follow up period was 67 months (range: 38 to 149 months). RESULTS: Two cases (7.7%) experienced ipsilateral breast tumor recurrence (IBTR) after BCS-RT. The histology results at the time of IBTR showed invasive ductal carcinoma (IDC), and the median time to IBTR was 25.5 months. On the univariate analysis, there were no significant factors associated with IBTR in the DCIS patients. The three-year local recurrence free survival rate was 96.0% and the overall survival rate was 96.3%. CONCLUSION: After the treatment for DCIS, the IBTR rate in our study was similar to other previous studies. Considering that we included patients who had many symptomatic lesions, close or positive margins and less that complete early data, our result is comparable to the previous studies. We could not find the prognostic significant factors associated with IBTR after BCS-RT. A longer follow up period with more patients would be required to evaluate the role of any predictive factors and to confirm these short-term results.

Transscleral fixation of a dislocated IOL through sclerotomy.

We describe a technique for knotting a suture to the haptic of a dislocated intraocular lens (IOL) through a sclerotomy site without removing an IOL in 4 patients. The suture was knotted to the haptic from outside the sclera. The remaining suture material was tied together and buried in the sclerotomy site. To prove that we could suture to the haptic safely, experiments were carried out using 4 scleral shells of donor eyes. No complications occurred, and good visual recovery was achieved. In this method, the haptic can be tied safely through the sclerotomy site and reduce the risk for knot-related complications. To our knowledge, this approach has not been reported.

Surgical management of crystalline lens dislocation into the anterior chamber with corneal touch and secondary glaucoma.

We present a 53-year-old man with a crystalline lens that spontaneously dislocated anteriorly with corneal touch and secondary glaucoma. A dry anterior vitrectomy and partial intercapsular lensectomy were performed using a limbal approach to control intraocular pressure (IOP) and decrease the lens volume. The lens capsule was gently separated from the corneal endothelium with viscoelastic material, after which a bimanual lensectomy was performed with a vitrectomy probe and a phacoemulsification microflow tip. The risk for expulsive choroidal hemorrhage, which can occur during large-incision, open-chamber surgery; a sudden IOP decrease; and significant damage to the corneal endothelium were avoided with this technique. After secondary intraocular lens scleral fixation, the final visual acuity was 20/25.

A case of bilateral oculomotor nuclear palsy.

To the best of our knowledge, isolated bilateral oculomotor nuclear palsy has not yet been reported in the literature, while bilateral oculomotor nuclear palsy with more widespread rostral brainstem infarction has often been reported. We present a patient having 'top of the basilar syndrome' with midbrain infarction selectively involving the bilateral oculomotor nucleus. A 61-year-old woman with two episodes of vertebrobasilar infarction presented with sudden onset of bilateral ptosis. Examination revealed pronounced bilateral ptosis. In the primary position, fixation of either eye produced an approximately 50 prism diopter exotropia. Adduction of the right eye was restricted to the midline. There was moderately decreased adduction of the left eye, severe limitation of depression, and moderately decreased elevation of both eyes. Abduction of both eyes was normal. The pupils were equal, round, and reactive to light. Bilateral ptosis is suggestive of oculomotor nuclear palsy. On the basis of clinical findings alone, we could not establish whether the precise location of the lesion was all the subdivisions of the oculomotor nucleus except the Edinger-Westphal nucleus or the central caudal nucleus and bilateral fascicles. However, because axial MRI showed a small midbrain infarct in the oculomotor nucleus region, we concluded that she had an isolated, pupil-sparing, bilateral oculomotor nuclear palsy caused by midbrain infarct.

hOGG1 Ser326Cys polymorphism modifies the significance of the environmental risk factor for colon cancer.

AIM: To determine the association of hOGG1 (8-oxoguanine glycosylase I, OGG1) polymorphism of Ser326Cys substitution with colon cancer risk and possible interaction with known environmental risk factors. METHODS: A case-control study with 125 colon cancer cases and 247 controls was conducted. RESULTS: There was no major difference in Ser326Cys genotype distribution between cases and controls. The meat intake tended to increase the odds ratio for colon cancer with an OR of 1.72 (95 % confidence interval; CI=1.12-2.76). Such tendency was more prominent in Cys/Cys carriers (OR=4.31, 95 % CI=1.64-11.48), but meat intake was not a significant risk factor for colon cancer in Ser/Ser or Ser/Cys carriers. The OR for colon cancer was elevated with marginal significance in smokers who were Cys/Cys carriers (OR=2.75, 95 % CI=1.07-7.53) but not in Ser/Ser or Ser/Cys carriers. CONCLUSION: These results suggest that the hOGG1 Ser326Cys polymorphism is probably not a major contributor to individual colon cancer susceptibility overall, but the Cys/Cys genotype may alter the impact of some environmental factors on colon cancer development.

Clinical results of a scleral fixation of the posterior chamber intraocular lens, through sclerotomies, 1 mm posterior to the limbus.

The aim of this study was to evaluate the clinical outcomes of scleral fixation of a posterior chamber intraocular lens and an anterior vitrectomy through sclerotomies, 1 mm posterior to the limbus. The study comprised of seven eyes that required a scleral fixation. Sclerotomies, 1 mm posterior to the limbus, were performed using a 20G sclerotome at the 2 and 8 o'clock positions. Group 1 was defined as four eyes requiring scleral fixation of the secondary IOL (Intraocular lens), and group 2 as three eyes where dislocated IOLs were repositioned and fixed to the sclera via sclerotomy sites. In all the eyes, the knot of string (10-0 prolene, W1713, Ethicon, USA) was buried. Postoperatively, the visual acuity was greatly improved, by more than 4 lines in the Snellen visual acuity chart, with the exception of one case of macular degeneration. The scleral fixation of the IOL through sclerotomies, 1 mm posterior to the limbus, had advantages in that the scleral fixation of the IOL could be achieved through sclerotomy sites, and the anterior vitrectomy parallel to the iris plane.

Down regulation of bcl2 expression in invasive ductal carcinomas is both estrogen- and progesterone-receptor dependent and associated with poor prognostic factors.

In normal breast, Bcl2 is expressed in the non-pregnant and non-involuting mammary epithelium. The exact mechanism and the effect of the down regulation of the Bcl2 expression on breast cancer cells are not clearly defined. We compared down regulation as well as the persistent expression of Bcl2 with ER, PR, p53, and c-erb-B2 overexpression and clinicopathologic variables, and tumor stage in 11 cases of ductal carcinomas in situ (DCIS) and 44 cases of invasive ductal carcinomas (IDC) of Korean women by immunohistochemical studies. Bcl2 down regulation was found in 39% of IDC and in 18% of DCIS cases. In IDC, while persistent Bcl2 expression was displayed in 95% and 78.9% of ER and PR immunoreactive ones and 71.9 % of c-erb-B2 immunonegative ones. Seventeen cases of Bcl2 down regulated IDC had a significant correlation with ER negativity (94.1%), PR negativity, (76.5%), and high nuclear (61.1% is grade III) and histological grade (76% is grade III). However, in DCIS, no significant correlation between the Bcl2 expression and various parameters were obtained, probably due to small sample size. In conclusion, the Bcl2 expression was both ER and PR dependent and down regulation of Bcl2 in IDC was significantly correlated with poor prognostic factors.

Clinical feature of unintended thin corneal flap in LASIK: 1-year follow-up.

To purpose of this study was to evaluate complications of unintended thin corneal flap in laser in situ keratomileusis (LASIK), such as visual acuity and myopic regression, at the one year follow-up. We performed a study on 54 eyes, i.e. 27 patients, having LASIK. The eyes were split into two groups, group one, 27 eyes with unintended thin corneal flap with a thickness of 100 microm or less, and as a control group, 27 eyes with a thickness of 110 microm or more. The average corneal flap thicknesses of the two groups were 88.89 +/- 8.07 microm and 132.70 +/- 19.58 microm, respectively. With regard to postoperative complications, there were no statistical differences between the groups for: foreign bodies in aspects of the interface, mild peripheral infiltration, superficial punctuate keratitis, myopic regression and decreased vision. The only complication showing any statistical difference between the two groups was the central corneal opacity. An unintended thin corneal flap, with an intact Bowman's layer, induced no significant postoperative complications. Central corneal opacity was apparent in 4 of the eyes in group one, so may be related with a thin corneal flap.