Uncomplited Epithelial Breakthrought During Femto Flap Creation For Lasik.

My purpose is to show next day slit-lamp findings  after not completed vertical gas breakthrough (cavitation bubbles under Bowman’s membrane) during flap creation for Lasik. Photo shows traces of cavitation bubbles under the epithelium of corneal flap.

Ophthalmosurgical center " Noviy Zir", Kyiv, Ukraine.

This intraoperative complication have happened during Femto Lasik on right eye of the patient who has high myopia. Flap was lifted and ablation was performed as a surgeon didn`t find any damage of epithelium. Next day the slit lamp picture showed traces of cavitation bubbles under the epithelium of corneal flap which decreased visual acuity to 20/40 on right eye. Those epithilial alteration led to the development of flap strias which have been  managed by lifting the flap in 3 months after Femto Lasik. 

We know that in case of vertical gas breakthrough formation the management will depends on localization and area of damage.

In case of a large area cavitation bubbles under Bowman’s membrane formation it would be better to abort ablation and continue with surface ablation after 3 months.