Managing Laser Based Refractive Surgery Complications

The objective of our presentation is to show some clinical cases of post refractive surgery complications, risk factors, implications  and the management carried out.

- Cross sectional study

- All patients requiring laser correction are included

-All patients with contindication to laser correction are excluded

- All patients are benefited and followed by cornal topography, OCT A and aberrometry

We conducted a cross-sectional study for one year (January 2022-January 2023) in our ophthalmology clinic covering 700 eyes of 350 patients who underwent different types of laser refractive surgery (PKR/Trans PKR/Lasik).

We reported clinical cases of the complications that occurred with emphasis on the established risk factors, impact on the cornea (using OCT of the SA, topography and abberometry) as well as the treatment.

The first  case is central toxic keratopathy CTK in a 19-year-old female patient.

A case of diffuse lamellar keratitis DLK in a 23-year-old patient.

A case of an eccentric flap in a 21-year-old patient.

The complications of laser refractive surgery are essentially divided into two parts:

- Intraoperative complications

- Post-operative complications

There are many post-operative complications.

Diffuse lamellar keratitis is an inflammation that occurs between 1-3 days postoperatively but also many years after epithelial damage.

There are 04 grades of DLK.

Treatment varies according to each grade but the initial intervention is to lift the flap and irrigate.

Central toxic keratopathy similar to DLK but treatment is totally delayed.

In the decentered flap we must perform femto laser with a wider and deeper Cut or the Trans PRK.

Prevention is better than treatment.

The risks and benefits of refractive surgery must be weighed to choose the best solutions.

A comprehensive and systematic approach should be followed to reduce the risk of complications.