Double Femtosecond Laser Created Incomplete Flaps After Repeated Docking

Purpose: To report a case of femtosecond laser flap complication in the form two incomplete flaps after repeated separate docking procedures.

Methods: a 28-year-old female complaining of bilateral defective vision due to high myopia in right eye and subjected to right Femtosecond laser for flap creation for laser-assisted in situ keratomileusis (Lasik). After suction release we found that the created flap was decentered with flap edge near the pupil which will interfere with excimer laser ablation. So, the decision was to postpone the surgery. Another trial for Femtosecond laser flap creation with the same parameters of the previous trial with the same flap depth 90um. During flap lifting the flap was found to be divided into 2 parts, one peripheral crescent the other is incomplete circular flap. Both parts were lifted with underlying wide ablation zone. After excimer laser treatment, both parts were repositioned to their respective places. Contact lens was applied at the end of the procedure.

Result: After 2 months of follow up complete healing of the flap has occurred with satisfactory refractive result.

Conclusion: Flap decentration and incomplete flaps can occur with femtosecond laser flap creation. More notable conclusion is that femto flap edge healing is not so tight as thought before.

Keywords: Femtosecond laser; Docking; Incomplete flaps