Late post-traumatic flap dislocation and macrostriae after laser in situ keratomileusis

Sinha, Rajesh; Shekhar, Himanshu; Tinwala, Sana; Gangar, Anita; Titiyal, Jeewan S

doi:10.4103/0974-620x.127919

Cited by 10 publications

(10 citation statements)

References 11 publications

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“…Due to our interest in the prevalence of traumatic flap displacement after LASIK, we reviewed several reports published in the previous ophthalmic literature with complete data from 2000 to 2014 on cases of late-onset traumatic flap dislocations or displacements after LASIK ( Table 1 ). 4 – 15 We reviewed a total of 19 cases of patients with an average age of 35 years, of whom 52.6% were male. Regarding the causes of injury, over 26% of injuries were due to sport-related activities, followed by work-related accidents (15.7%), animal injuries (10.5%) and failure of airbags during car accidents (10.5%).…”

Section: Literature Reviewmentioning

confidence: 99%

Traumatic corneal flap displacement after laser in situ keratomileusis (LASIK)

Tsai¹,

Peng²

2017

IMCRJ

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BackgroundLaser in situ keratomileusis (LASIK) is the most common and popular procedure performed for the correction of refractive errors in the last two decades. We report a case of traumatic flap displacement with flap folding which occurred 3 years after LASIK was performed. Previous literature suggests that vision prognosis would be closely related to proper and prompt management of traumatic flap displacement with flap folding 3 years after LASIK.Case presentationA 23-year-old female presented to our hospital who had undergone uneventful LASIK in both eyes 3 years prior. Unfortunately, she had suffered a blunt trauma in her right eye in a car accident. A late onset of corneal flap displacement was found with upper and lower portion of the flap being folded inside the corneal bed. Surgical intervention for debridement with subsequent reposition of corneal flap was performed as soon as possible in the operating room. A bandage contact lens was placed, and topical antibiotic and corticosteroids were given postoperatively. Two days after the operation, the displaced corneal flap was found to be well attached smoothly on the corneal bed without folds. The best-corrected visual acuity was 6/6 with refraction of −0.75 D to 1.0 D ×175° in her right eye 1 month later.Literature reviewWe reviewed a total of 19 published cases of late-onset traumatic flap dislocations or displacements after LASIK with complete data from 2000 to 2014.ConclusionTraumatic displacement of corneal flaps after LASIK may occur after blunt injury with specific direction of force to the flap margin, especially tangential one. According to the previous literature, late-onset traumatic flap displacement may happen at any time after LASIK and be caused by various types of injuries. Fortunately, good visual function could mostly be restored with immediate and proper management.

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Section: Literature Reviewmentioning

confidence: 99%

Traumatic corneal flap displacement after laser in situ keratomileusis (LASIK)

Tsai¹,

Peng²

2017

IMCRJ

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“…Our case is the latest-onset of traumatic epithelial ingrowth, 15years after initial LASIK, and the only case without flap displacement. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In the current case, epithelial ingrowth resolved on slit lamp exam after flap lift, debridement, and drop treatment; visual symptoms did not return. How the epithelial cells were introduced under the corneal flap remains unclear.…”

Section: Discussionmentioning

confidence: 89%

“…Even years after LASIK, only minimal adhesions may hold the flap to the stroma, leaving the rest of the interface patent and predisposing the flap to displacement after trauma. 6 Figure 3 describes reported cases of traumatic LASIK flap epithelial ingrowth. Mean patient age was 36 and the female to male ratio was 1:0.67.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Epithelial Ingrowth Despite Non-Displaced Lasik Flap

Aboumerhi¹

2015

MOJCR

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A 50-year-old female developed significant aggressive epithelial ingrowth after a minor corneal abrasion to her left eye, which required surgical removal. On presentation, she exhibited no signs of corneal flap manipulation or displacement. This report exemplifies the latest presentation of traumatic epithelial ingrowth from initial LASIK surgery and the only case without flap displacement, emphasizing the need for close follow-up and examination of all LASIK patients even after minor trauma.

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“…Once a patient undergoes LASIK surgery, the cornea heals exclusively at the periphery of the microkeratome wound away from the visual axis, thereby leaving a persistent potential space under the flap. Even years after LASIK, only minimal adhesions may hold the flap to the stroma, leaving the rest of the interface patent and predisposing the flap to displacement after trauma [6]. Table 1 describes reported cases of traumatic LASIK flap epithelial ingrowth.…”

Section: Discussionmentioning

confidence: 99%

“…Two cases did not require debridement of epithelial ingrowth; one case in the series involving corneal perforation mandated penetrating keratoplasty. Our case is the latest-onset of traumatic epithelial ingrowth, 15 years after initial LASIK, and the only case without flap displacement [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]20]. …”

Section: Discussionmentioning

confidence: 99%