Mechanical penetration of a femtosecond laser-created laser-assisted in situ keratomileusis flap

Purpose: We report a case of mechanical flap penetration during LASIK using the Intralase femtosecond laser. Methods: Case Report. Results: A 50-year-old hyperope planned to have LASIK using the Intralase femtosecond laser. During the creation of the flap, a gas bubble formed anterior to the flap. This area was noted to be adherent to the cornea. Attempts to lift the flap resulted in flap penetration. The case was aborted, and the flap was repositioned. At postoperative week one, the patient's visual acuity was restored to preoperative levels. Conclusions: When a gas bubble appears during the creation of a LASIK flap with the Intralase femtosecond laser, we recommend waiting for the bubble to disperse. If significant resistance is encountered during the lifting of the flap, we suggest aborting the case.