Abstract
Abstract: :
Purpose: To describe three cases of LASIK flap dislocation resulting from minor trauma. Methods: Descriptive case series. Results: We report three cases of corneal flap dehiscence presenting to the Mayo Clinic Emergency Room between November 2001 and March 2002. These injuries occurred twelve, thirteen, and twenty-four months after LASIK. All three cases resulted from trauma. Traumatic events included: injury from a dog's paw (n=1, 24 months postop); branch injury while hiking; (n=1, 13 months postop); and inadvertent self-injury with a finger while toweling hair dry (n=1, 12 months postoperatively). In all cases the patients reported to an eye care provider and at a medical center unassociated with their initial surgery. The initial uncorrected visual acuities were 20/30 (paw), 20/400 (finger), and 20/30 (branch). In each case, the dislocated portion of the flap was folded inward, so that the epithelial surface was intact with the bare stromal bed. Emergent treatment in all cases included irrigation and debris removal from the exposed stromal bed, repositioning and smoothing of the corneal flap, and placement of a bandage contact lens. The final uncorrected visual acuity was 20/20 in each case. Complications included; two cases of diffuse lamellar keratitis, one case with persistent corneal flap folds, and two cases of isolated clusters of epithelial cells within the corneal flap-stromal bed interface. Conclusions: Dislocations of the corneal flap created at the time of LASIK can occur many months after the primary procedure. These dislocations can occur with relatively minor trauma and during activities of normal daily life. Despite complications, all three patients recovered excellent uncorrected visual acuity.
Keywords: refractive surgery: LASIK • refractive surgery: complications • trauma