Confocal Microscopy of a Femtosecond Laser LASIK Flap Before Separation

Purpose: To describe stromal changes after a femtosecond laser laser-assisted in situ keratomileusis (LASIK) flap was created but not separated. Design: Case report. Methods: As part of a randomized paired-eye study comparing LASIK flap creation by a femtosecond laser to a mechanical microkeratome, a femtosecond laser flap was successfully created on one eye of one patient, but the flap was not separated because of a flap-related complication in the fellow eye. Confocal microscopy of the femtosecond laser flap was performed before and at intervals after it was created. Results: Activated keratocytes and interface haze were visible at one day after femtosecond laser treatment, with gradual resolution toward normal over two months. The femtosecond laser flap was easily separated four months after it was created. Conclusions: Corneal photodisruption by the femtosecond laser is associated with transient keratocyte activation and corneal haze, but marked wound healing does not occur to hinder flap separation several months later.