Outcome of Cornea, Iris, and Lens Perforation During Automated Lamellar Keratectomy

Automated lamellar keratectomy (ALK) for correction of myopia is a procedure requiring creation of a hinged partial-thickness corneal flap followed by removal of a midstromal corneal disc. Very few reports of outcomes and complications of this procedure have been published.1A serious intraoperative complication of ALK for myopia is reported here. Report of a Case. A 31-year-old woman had a history of contact lens intolerance after 10 years of wear. Visual acuity was 20/20 in each eye with −9.75 diopters (D) OD and −9.00 D OS. On the day prior to referral, ALK was attempted on the right eye with topical anesthesia. During the initial pass of the automated keratome, at an intended depth of 160 μm with a nasal hinge, the cornea was perforated for the entire flap boundary with incision of the inferior iris and the center of the lens. The corneal wound was immediately repaired with