Single versus double femtosecond laser pass for incomplete laser in situ keratomileusis flap in contralateral eyes: Visual and optical outcomes

PURPOSE: To evaluate visual acuity, refractive outcomes, and anterior corneal higher-order aberrations (HOAs) after myopic laser in situ keratomileusis (LASIK) with uneventful single femtosecond laser pass versus double pass performed for intraoperative suction loss. SETTING: Private refractive surgery center, Valencia, Spain. DESIGN: Cohort study. METHODS: After the LASIK flap was created with a single pass of an Intralase femtosecond laser in 1 eye and a double pass in the fellow eye, the ablation was performed with a Visx S2 laser. At 12 months, the refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, and anterior corneal HOAs were measured with 4.0 mm and 6.0 mm pupils. RESULTS: The study enrolled 42 eyes (21 patients). Twelve months postoperatively, there were no statistically significant differences in any parameter studied including residual spherical equivalent (mean -0.05 diopter [D] +/- 0.25 [SD] single pass; -0.03 +/- 0.19 D double pass; P=.75), UDVA (mean 0.008 +/- 0.057 logMAR single pass; 0.011 +/- 0.046 logMAR double pass; P=.89), CDVA (mean -0.010 +/- 0.040 logMAR single pass; -0.007 +/- 0.037 logMAR double pass; P=.74), or anterior corneal HOAs. No eye lost 1 line of CDVA. CONCLUSIONS: Visual acuity, refractive outcomes, and anterior corneal HOAs were comparable between eyes after uneventful femtosecond laser single pass or double pass after suction loss affecting the pupillary area. A new femtosecond laser pass performed immediately after incomplete flap due to intraoperative suction loss provided good visual and optical outcomes.