Artemis very high-frequency digital ultrasound guided femtosecond laser recut after flap complication

Incomplete flaps are a relatively uncommon complication of laser-assisted in situ keratomileusis (LASIK) that occur when creation of the corneal flap is interrupted. Further complications can arise if a second flap is created that intersects the original flap interface, resulting in tissue slivers that can lead to more complications and poor visual outcomes. We report the case of a 56-year-old man who underwent LASIK in which an incomplete flap occurred after 45% completion using a mechanical microkeratome with a 160 µm head. The maximum depth achieved by this incomplete flap was measured by very high-frequency (VHF) digital ultrasound as 182 µm peripherally. Two months later, a second flap was created beneath the incomplete flap, at a depth of 190 µm. The resulting flap had a central thickness of 196 µm and a minimum clearance of 30 µm beneath the incomplete flap. This demonstrates a method for creating secondary flaps that may significantly reduce the risk of flap interface intersection.