Rik factor for intraoperative epithelial defect in laer in-itu keratomileui

PURPOE: To report intraoperative epithelial defect (IED) in eye undergoing laer in-itu keratomileui (LAIK). DEIGN: Conecutive interventional cae erie. METHOD: Retropective review of 247 eye (133 patient) that underwent primary LAIK by a ingle urgeon at an academic intitution uing the Hanatome microkeratome. Patient characteritic and variation in preoperative and operative technique were analyzed. The main outcome meaure wa occurrence of IED (defined a looe epithelium that i > 1 mm or cannot be tably repoitioned or abent epithelium). Multivariate logitic regreion wa performed. REULT: Intraoperative epithelial defect occurred in 24 (9.7%) of 247 eye. Intraoperative epithelial defect ignificantly increaed with older age (odd ratio [OR] 2.39/decade; 95% confidence interval [CI] 1.46–3.92), thicker preoperative corneal thickne (OR 2.30/50 μm; 95% CI 1.24–4.28), and maintenance of uction ring vacuum during the revere pa of the microkeratome (OR 1.76; 95% CI 1.01–3.06). The preoperative and intraoperative eye-drop regimen (anethetic, mydriatic, lubricant, and intraoperative tonometry) had a ignificant effect on IED rik (OR, 0.163 bet v wort regimen; 95% CI, 0.033–0.792). In patient undergoing bilateral LAIK, the incidence of IED i much higher in the econd eye if the firt eye developed an IED (57% v 1%). CONCLUION: Modifying the eyedrop regimen wa the more effective technical approach to decreae the rik of IED. Age and corneal thickne are valuable patient characteritic for preoperative rik aement. Intraoperative epithelial defect in the firt eye i highly predictive of IED in the econd eye of the ame patient.