Air Cannula Vs. Weckcel Sponge in Manipulation of Corneal Flap and Incidence of SPK (Superficial Punctate Keratitis) after LASIK

Vipul Bhandari*, Jagadeesh K. Reddy and Vineet Joshi

Air Cannula Vs. Weckcel Sponge in Manipulation of Corneal Flap and Incidence of SPK (Superficial Punctate Keratitis) after LASIK

Laser-assisted in situ keratomileusis today is the commonest
corneal refractive surgery performed around the world.

As with every surgical procedure the post-operative complications
of LASIK affect the patient satisfaction and outcome of the surgery.

Superficial punctuate keratitis in the form of superficial punctuate
epithelial erosions are one of the earliest complications noted
within hours after surgery in the early post-operative period.

It not only affects the patient satisfaction but can be an early sign of forth coming complications
after LASIK. Though the SPKs as a part of post-LASIK dry eye often develops at around 6
months post-operatively, the pathogenesis behind
the early post-operative SPKs is likely to be different.

Damage to the epithelium in such cases is likely to be due to intra-operative methods
used to handle the corneal flap. Various pre-operative patient related factors and
different intraoperative techniques play an important role.

Pre-operative factors are like an age of more than 40 years, hyperopia, greater corneal
thickness, and surface drying during the microkeratome’s pass have shown greater
risk of corneal epithelial defects after LASIK.

Certain intra-operative factors like, use of anaesthetic eye drops, site of hinge
of corneal flap, use of microkeratome or Femto Second laser, thickness
of corneal flap, affect the incidence of corneal epithelial defects.

Statistical Analysis System software was used for randomization
of the eyes to either of the groups, Air canula group or the Weck-cel sponge group.

A Chi-square test was used with 1 degree of freedom to find which surgical
technique had an association with higher grades of SPK.

Ophthalmol Open J. 2015; 1(1): 5-8. doi: 10.17140/OOJ-1-102