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Single-step trans-epithelial photorefractive keratectomy as an early treatment of LASIK flap buttonholes

Session Details

Session Title: Surface Ablation II

Session Date/Time: Tuesday 08/10/2013 | 16:30-18:00

Paper Time: 17:15

Venue: Main Lecture Hall (Ground Floor)

First Author: : S.Awwad LEBANON

Co Author(s): :    H. Wehbe   M. Abdel Al           

Abstract Details


To evaluate the safety and efficacy of single-step trans-epithelial PRK (TransPRK) in treating buttonholes in the early period after their occurrence.


American University of Beirut Medical Center


Case-series of 7 eyes of 7 patients who developed buttonholes after undergoing bilateral myopic Laser in-situ keratomileusis. The procedure in the involved eye was aborted in all cases, the flap was carefully repositioned, and a single-step trans-epithelial PRK was performed using the Schwind Amaris excimer laser as soon as the epithelial defect healed and the epithelium regained a smooth luster with no negative fluorescein uptake (5-7 days later for all eyes).


Uncorrected visual acuity in the treated buttonhole eyes was 20/25 or better in 80% 2 weeks, and in 100% at 4 weeks postoperatively, while 86% and 100% were 20/20 or better at 4 weeks postoperatively, respectively. The mean spherical equivalence and cylinder refraction were -0.025±0.16 D and -0.25 ± 0.24D, respectively at 3 months postoperatively. No eye developed stromal haze.


Single-step trans-epithelial PRK performed early after the occurrence of LASIK buttonholes is safe and effective, while providing early recovery and smooth visual rehabilitation.

Financial Interest:


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