PURPOSE: To describe the visual outcomes of three patients who had LASIK flap buttonhole and were treated immediately with photorefractive keratectomy (PRK) and topical mitomycin C (MMC) 0.02%. METHODS: Three patients underwent bilateral LASIK with the SCHWIND Carriazo-Pendular 90-μm head microkeratome. In all three cases, a buttonhole flap occurred in the left eye. The flap was repositioned and phototherapeutic keratectomy for 50 μm was used for epithelial removal while immediate PRK with MMC was performed to treat the buttonhole flap. RESULTS: Three months after the procedure, uncorrected distance visual acuity and corrected distance visual acuity were 20/20 with regular topographic findings. CONCLUSIONS: Using PRK with MMC immediately after the occurrence of a LASIK flap buttonhole may be an effective treatment.
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