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Main types of dystrophic complications on the corneal flap associated with laser specialized keratomileusis (LASIK) are discussed. A total of 6507 down-up LASIK operations were performed. The most grave form of corneal flap disadaptation syndrome (CFDS) (central dystrophy) occurred in 1.59% cases only in patients with myopic keratoablation. Slight manifestations of this syndrome were observed in patients with myopia and hypermetropia. The authors discuss a concept of CFDS development in which the leading role is attributed to the initial disagreement between the size of corneal flap before and after keratoablation. The incidence of such complications depends on the method of corneal flap positioning during the final phase of the operation. Clinical picture, outcome, and treatment of CFDS are discussed.

Complications of specialized laser keratomileusis (LASIK) are analyzed in 1667 patients with 1.0-19.5 diopter myopia and hypermetropia of +2.25-10.0 diopters. LASIK was carried out by the standard method using Hansatome TM 230 HT device and eximer laser Nidek EC-5000. Classification of LASIK complications depending on the mechanism of exposure and stage at which they manifest is offered. Such complications as inadequate adaptation of the corneal flap (0.7%), lensodonesis (0.1%), viral keratitis (0.05%), turned-under edge of a flap (0.4%), stromal "feedback" pouch are described for the first time. Causes of complications are enumerated and analyzed and methods for their correction are described. The authors claim that the type and incidence of LASIK complications are largely determined by the experience of the surgeon and quality of equipment. Use of new lasers and new keratomes will rule out many complications.

Laser in-situ keratomileusis has been performed on 2023 eyes of 1162 patients with myopia of 1-18 diopters and complex myopic astigmatism of 0.75-5 diopters. A Hansatome TM 230 HT keratome and Nidek EC 5000 eximer laser device were employed. The resultant refraction and visual acuity were analyzed during one year postoperation in different age groups and groups with myopia of different degree. In myopia of up to 6 diopters high visual acuity without correction (0.93-0.99) was attained in all age groups. In higher myopia, visual acuity has been increasing over the entire period of observation, the gradient of its alteration being 0.17-0.27. The final visual acuity formed in presbiopes during 3 months. The spherical refraction equivalent of up to 1 diopter was 96.1%. The mean refraction values were stable during the entire period of observation. In myopia of 9.5 diopters and higher the residual myopia in patients aged over 30 years was approximating 1.0 diopters. Hypercorrection was observed in 1.3%, hypocorrection in 2.6% cases. The described combination of equipment for laser keratomileusis provides stable visual and refraction results at a lower incidence of complications.