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Subepithelial gas breakthrough during femtosecond flap creation

Poster Details

First Author: S.Tongal TURKEY

Co Author(s):    E. Toprak Un   F. Ondes           

Abstract Details


To report a case of hyperopic lasik in which a vertical gas breakthrough occured during IntraLase femtosecond flap creation.


Dunya Eye Hospital, Atakoy, Istanbul, Turkey


We planned a hyperopic IntraLase lasik to a 53 years old male patient. His ocular examination was normal except that he had an inferior parasantral anterior stromal 1mm scar on his left eye. Because of this scar we planned a 120 micron thick flap. During the flap creation in a raster mode, about 4 mm diameter subepithelial gas breakthrough was noted in the inferior part of the cornea. We waited for an hour and than corneal OCT was done and we noted flap was regular and decided to the do operation.


The surgeon was able to lift the flap without a buttunhole formation, but the epithelium was sloughy in both eye . The ablasion procedure was performed and the flap was repositioned. On the 1. Postoperative day , although the epithelial healing was complated , the contact lens set in place for 3 days . On the 3. Postoperative day , the uncorrected visual acuity was 20/20 in both eyes.


Epithelial sloughy and corneal scar tissue may have been the cause of subepithelial gas breakthroug in this patient. Fibrotic corneal tissue may increase the resistance to an effective plane of seperation and may associate with this kind of complications. If there is an anterior corneal scar, an increased flap depth may contribute to a flap interface that is posterior to the scarring and may prevent flep complications.

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