Bilateral Complicated Stromal Dissections during Mechanical Epikeratome Separation of the Corneal Epithelium

PURPOSE: To present a case of bilateral inadvertent stromal cuts during mechanical epikeratome separation of the corneal epithelium using a Centurion SES epikeratome (Norwood EyeCare Pty Ltd). METHODS: A 25-year- old woman underwent epi -LASIK surgery. Preoperative examinations showed no remarkable findings. After epithelial flap creation, a linear stromal cut near the temporal upper flap edge was found in the right eye. An irregular stromal cut involving the central cornea was found in the left eye after undergoing epi-LASIK with a new separator. Excimer laser ablation was continued in both eyes without flap reposition. RESULTS: Six months postoperatively, best spectacle- corrected visual acuity was 20/20 in the right eye and 20/25 in the left eye. Corneal topographic examination revealed a regular pattern in the right eye and irregularities in the left. CONCLUSIONS: Stromal dissection during mechanical separation of the corneal epithelium with a Centurion SES epikeratome is a potential complication of epi-LASIK. Visual impairment can result from such complications