Confocal microscopic imaging of reticular folds in a laser in situ keratomileusis flap

J Refract Surg. Nov-Dec 2001;17(6):689-91.


Purpose: To report the clinical and confocal microscopic characteristics of reticular folds (mudcracks) in a cornea after laser in situ keratomileusis (LASIK).

Methods: A 30-year-old male showed reticular flap folds on slit-lamp examination 1 week after LASIK. In addition to slit-lamp biomicroscopy, confocal in vivo microscopy was performed.

Results: Examination with a confocal white-light slit-scanning microscope revealed distinct folds of Bowman's layer and underlying microfolds throughout the flap stroma. After flap re-lifting, no changes could be determined, either clinically or by confocal microscopy. At 12 months following the procedure, best spectacle-corrected visual acuity was slightly improved, but the folds, as imaged by confocal microscopy, still persisted.

Conclusions: In the present case, reticular folds after LASIK involved the entire thickness of the flap. Simple flap lifting was not sufficient for smoothing out the folds.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Corneal Diseases / diagnosis*
  • Corneal Diseases / etiology
  • Corneal Diseases / surgery
  • Corneal Stroma / pathology*
  • Humans
  • Keratomileusis, Laser In Situ / adverse effects*
  • Male
  • Microscopy, Confocal
  • Myopia / surgery
  • Reoperation
  • Surgical Flaps / pathology*
  • Visual Acuity