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BRIEF COMMUNICATION
Year : 2017  |  Volume : 65  |  Issue : 7  |  Page : 618-620

Topography-guided neutralization technique for the management of flap complication in laser in situ keratomileusis


Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India

Correspondence Address:
Chaitra Jayadev
121/C, Chord Road, 1st ‘R’ Block, Rajaji Nagar, Bengaluru - 560 010, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_66_17

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A 29-year-old male was referred following a flap loss after the creation of a thin, irregular flap with a visual acuity of logMAR 0.1 with −2.0 DS−2.75 DC × 175°. Corneal topography and anterior segment optical coherence tomography revealed an irregular corneal curvature and epithelial profile. Phototherapeutic keratectomy (PTK) followed by Topography - Guided Custom Ablation Treatment (TCAT), as a modification of the topographic neutralization technique protocol, was planned to regularize the corneal surface and treat the residual refractive error. Postoperatively, the patient showed a best-corrected visual acuity of logMAR 0 with a refractive error of −1 DC × 90°. Regularization of topography and epithelial thickness was seen along with a reduction in astigmatism and higher order aberrations. We report the use of PTK followed by TCAT as a novel method to treat a case of intraoperative flap loss during laser in situ keratomileusis.


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