DR. BARKHA GUPTA

, DR. AMIT GUPTA, Dr. SUPRIYA DHAR, Dr. MUSKAAN BANSAL

Abstract

A 27yrs/ F undergoing LASIK outside, presented with blurred vision after 1 month. Her BCDVA was 6/18 OD & 6/12 OS with raised IOP, fluid vacuoles in the interface depicting pressure induced stromal keratopathy (PISK). Also, multiple central flap macro- striae were noticed OD. Steroids stopped and glaucoma therapy started. Flap macrostriae were treated surgically. Intraoperatively, a free cap without hinge was noticed. Flap was re-lifted, hydrated, re-positioned with repeated stroking and smoothening, sutures applied to secure flap to stromal bed and margins sealed with fibrin glue. Sutures were removed at 3weeks providing UDVA of 6/9. Free cap is a rare intraoperative complication seen with microkeratome that may affect vision. Therefore, proper pre-operative measures including patient selection, suction ring size could help prevent complications and sequelae. Prolonged steroid use should be avoided. Early detection and management of LASIK flap complications provides optimal outcomes.