UNASSIGNED: This case report describes a rare case of fungal keratitis following femtoLASIK. Despite targetted antifungal therapy, this case necessitated an innovative surgical approach to manage an unexpected corneal perforation.
UNASSIGNED: A 35-year-old male presented 3 weeks post-femtoLASIK for myopic astigmatism with discomfort and reduced vision in his right eye. He was diagnosed with fungal keratitis surgery caused by Purpureocillium lilacinum and was treated with a myriad of therapy. Unfortunately, the patient developed corneal perforation during flap lift and flap bed irrigation. An innovative approach involving a tectonic autograft using a viable LASIK flap, followed by prompt penetrating keratoplasty, was utilised.
UNASSIGNED: This technique was effective and able to mitigate the progression to an open globe.

A 28-year-old male underwent microkeratome assisted Laser-assisted in situ keratomileusis (LASIK) for, myopia. On postoperative day 1, patient had a large epithelial defect in OD. The corneal epithelial defect healed within 72 hours, but sub-optimal vision persisted. The patient was referred for further management to us. On evaluation, patient had non-healing of flap margin at 5 o\'clock. Fluoroscein stain revealed no corneal epithelial defect, but a large pool of dye beneath the LASIK flap. A clinical diagnosis of non-adherence of LASIK flap was considered. Application of bandage contact lens was done. LASIK flap completely healed in 1 week. Possible etiologies are discussed and literature is reviewed.

暂无摘要。

BACKGROUND: It is well known that the biomechanical properties change after LASIK refractive surgery. One reason is the impact of flap creation on the residual stroma. The results have revealed that the change is closely related with the flap thickness in several studies. However, the quantitative relationships between the distributions of displacement and stress on the corneal surface and flap thickness have not been studied. The aim of the study was to quantify evaluate the biomechanical change caused by the LASIK flap.
METHODS: By building a finite element model of the cornea, the displacement, the stress and the strain on the corneal surface were analyzed.
RESULTS: The results showed that the corneal flap could obviously cause the deformation of the anterior corneal surface. For example, the displacement of the corneal vertex achieved 15 μm more than that without corneal flap, when the thickness of corneal flap was 120 μm thick. This displacement was enough to cause the change of aberrations in the human eyes. In the central part of the cornea, the stress on the anterior corneal surface increased with flap thickness. But the change in the stress on the posterior corneal surface was significantly less than that on the anterior surface. In addition, the stress in the central part of the anterior corneal surface increased significantly as the intra-ocular pressure (IOP) increase. Furthermore the increase of IOP had a clearly less effect on stress distribution at the edge of the cornea. Distributions of strain on the corneal surface were similar to those of stress.
CONCLUSIONS: The changes in the biomechanical properties of cornea after refractive surgery should not be ignored.

We describe the use and safety of prednisolone acetate eyedrops at the end of laser in situ keratomileusis (LASIK) to aid proper positioning of the corneal flap. The LASIK flap is created using the preferred technique. Following laser ablation and flap repositioning, one drop of prednisolone acetate is instilled on the eye. This delineates the flap \"gutters\" and allows perfect flap positioning and centration. We used this technique in 425 eyes undergoing LASIK for correction of spherocylindrical refractive errors. Flap margins were adequately delineated intraoperatively. The only complication related to the use of the steroid suspension was crystal deposition under the flap in one case which resolved completely in 48 hours.