Uneventful Femtosecond Laser-assisted Flap Creation in a Patient With Postoperative PRK Corneal Haze.

To the Editor: Flap creation is the most crucial step of LASIK and the introduction of the femtosecond laser led to the production of uniform flaps enhancing the accuracy and reproducibility of LASIK.1,2 However, intrastromal corneal opacity (such as scar and haze) raised controversies regarding the efficacy of the technique in such cases because it can interfere with laser tissue disruption, causing gas breakthrough and/or irregular flaps in some cases.3,4 In our case, a patient with corneal stromal haze underwent uneventful femtosecond laser-assisted flap creation during LASIK. A 31-year-old man who had undergone photorefractive keratectomy with mitomycin C in his right eye 6 years earlier presented to our institute for consultation because of hyperopic astigmatism regression. Ocular history revealed amblyopia of the right eye, whereas his medical history was unremarkable. At presentation, uncorrected distance visual acuity was 20/125 in the right eye and 20/20 in the left eye, whereas corrected distance visual acuity was 20/25 (manifest refraction: +5.25 -5.25 35) and 20/20 (manifest refraction: +0.75 -0.50 35), respectively. Slit-lamp examination revealed a peripheral ring of stromal haze formed in a denser temporal semi-arcus (Figure 1A). Corneal haze was extended within a maximum depth of 116 μm as estimated using anterior segment optical coherence tomography (Visante OCT 3.0; Carl Zeiss Meditec, Inc., Jena, Germany) (Figure 1B). Central corneal thickness was 541 and 542 μm for the right and left eye, respectively. LASIK was proposed as an enhancement treatment because photorefractive keratectomy led to significant regression of the initial refractive error and haze