Effect of flap hinge placement on post-laser in situ keratomileusis wound healing in the presence of superior corneal vascularization

J Cataract Refract Surg. 2003 Dec;29(12):2448-51. doi: 10.1016/s0886-3350(03)00514-5.


We report a case that demonstrates a difference in wound healing after laser in situ keratomileusis using microkeratomes with both superior and nasal hinges in a patient with bilateral superior corneal vascularization. Subsequently, the patient experienced lamellar keratitis, epithelial defects, and peripheral thinning in both eyes. These postoperative conditions were more extensive and required more time to resolve in the eye with a nasal hinge flap. Creating a superiorly hinged flap decreases the likelihood of transecting extensive corneal pannus and may reduce the degree of postoperative complications.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Infective Agents / therapeutic use
  • Corneal Edema / drug therapy
  • Corneal Edema / etiology
  • Corneal Neovascularization / complications*
  • Corneal Stroma / surgery
  • Corneal Topography
  • Drug Therapy, Combination
  • Glucocorticoids / therapeutic use
  • Humans
  • Keratitis / drug therapy
  • Keratitis / etiology
  • Keratomileusis, Laser In Situ / adverse effects*
  • Male
  • Ofloxacin / therapeutic use
  • Postoperative Complications*
  • Prednisolone / analogs & derivatives*
  • Prednisolone / therapeutic use
  • Refractive Surgical Procedures
  • Surgical Flaps / adverse effects*
  • Wound Healing*


  • Anti-Infective Agents
  • Glucocorticoids
  • prednisolone acetate
  • Prednisolone
  • Ofloxacin