Double-folded “taco” corneal flap in LASIK correction of hyperopia

Objectives To assess double-folded “taco” corneal flap technique during hyperopic laser-assisted in situ keratomileusis (LASIK) correction by evaluating flap protection against accidental ablation, presence of undersurface debris, incidence of epithelial ingrowth, and visual recovery. Patients and methods This prospective randomized study included 24 hyperopic patients (48 eyes) undergoing LASIK with a double-folded “taco” corneal flap for the right eyes (group A) and a conventional reflected flap for the left eyes (group B). Flap integrity and the stromal interface were examined on postoperative day 1, week 1, and month 1. The predictability and treatment efficacy were evaluated at the final follow-up visit. Results Three eyes in group A demonstrated minor laser burns on the inferior epithelial margin, which resolved within 24 h. In contrast, six eyes in group B showed partial hinge ablation persisting for 1 week. Group A exhibited better predictability at 1 month (mean cycloplegic refraction SE +0.5±0.31 D) compared with group B (+0.67±0.39 D). Treatment efficacy was superior in group A. Interface debris was observed in two eyes of group B but not in group A. Conclusions The double-folded “taco” corneal flap technique may promote faster visual recovery after hyperopic LASIK, minimize accidental flap ablation, and reduce the risks of interface debris and epithelial ingrowth, potentially enhancing both predictability and treatment efficacy.