Late traumatic LASIK flap loss during contact sport

Tetz, Manfred; Werner, Liliana; Müller, Matthias; Dietze, U.

doi:10.1016/j.jcrs.2007.03.033

Cited by 23 publications

(20 citation statements)

References 15 publications

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“…Two patients were correctable to 20/25, and the third was correctable to 20/50 with a rigid contact lens. A report by Tetz et al 21 describes a patient struck in the eye by a finger 3 and a half years after microkeratome-created LASIK, resulting in complete flap loss.…”

Section: Discussionmentioning

confidence: 99%

Visual acuity recovery after late traumatic femtosecond laser in situ keratomileusis flap loss

Thomas

Tanzer

2009

Journal of Cataract and Refractive Surgery

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We report a case of traumatic flap loss from a fingernail 2 months after femtosecond laser-assisted laser in situ keratomileusis. On presentation, the patient's uncorrected visual acuity (UCVA) was 20/400 and complete flap avulsion was noted. Irrigation and treatment with mitomycin-C were done immediately, and a bandage contact lens was inserted. The epithelium healed completely over 1 week. One month after the injury, the UCVA was 20/15(-2). This case illustrates an excellent outcome from a potentially devastating event following refractive surgery in a military member.

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Section: Discussionmentioning

confidence: 99%

Visual acuity recovery after late traumatic femtosecond laser in situ keratomileusis flap loss

Thomas

Tanzer

2009

Journal of Cataract and Refractive Surgery

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“…In several circumstances, surface ablation may be a better option than LASIK; these include treatment of (1) patients prone to traumatic LASIK-flap dislocation (eg, army personnel and contact sport athletes), 26,27 (2) patients with relatively large pupils (who may experience symptoms of glare and halos in the event of flap decentration and an abrupt border of their wider-than-the-flap-diameter ablation), 24,25 (3) patients at risk for developing keratectasia (patients with thin or irregular corneas), 28 and (4) patients with very deep-set eyes, small palpebral fissures, or very prominent orbital roofs. 29 Similarly, corneal surface irregularities; hemimeridional asymmetry; very high or low keratometry readings; low pachymetry; and situations that may predispose to irregular, thin, or buttonholed flaps are better not treated with LASIK.…”

Section: Patient Indications and Assessmentmentioning

confidence: 99%

Surface ablation techniques

Taneri

Weisberg

Azar

2011

Journal of Cataract and Refractive Surgery

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The ongoing quest for a safe, simple, effective, minimally invasive, and stable refractive surgical procedure to correct refractive errors has stimulated the development of surface ablation techniques and laser in situ keratomileusis. In this review, we describe the history, patient assessment, techniques, outcomes, and complications of surface ablation (photorefractive keratectomy, laser-assisted sub-epithelial keratectomy, epithelial laser-assisted in situ keratomileusis) and compare the results of various surface techniques. Surface ablation procedures will continue to evolve, with potential improvements in outcomes accompanying future sophisticated ablation profiles and laser technology.

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“…2 Traumatic dislocation has been reported after 10 days, 3 1 year 4 and 3 years and 5 months. 5 Our report is the first to indicate the possibility of weak adhesion of the flap after a much longer time, i.e. 13 years.…”

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confidence: 56%

Partial flap avulsion following refractive surgery

Berger

Williams²,

Novis³

2010

S Afr Med J

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This case was challenging because of the long duration, presence of constitutional symptoms, recent ingestion of traditional medicament, shifting dullness and dullness in the flanks on clinical examination, previous non-significant rectal biopsy, ascites revealed on ultrasound examination, and unhelpful laboratory investigations. Refractive surgery, mainly laser in situ keratomileusis (LASIK), is widely used to correct refractive errors, mainly myopia. It consists of producing a corneal flap, ablating the underlying corneal stroma using laser energy, and repositioning the flap without suturing it to the underlying stroma.A 58-year-old man presented with blurred vision, pain and photophobia after suffering a minor injury on his right eye from a tree branch. He had had LASIK procedures 13 years ago for both eyes. The eye was congested, there was corneal fluorescein staining, and the corneal flap was partially detached and scrolled up (Fig. 1).Under local sub-conjunctival anaesthesia the flap was irrigated, cleaned, repositioned and sutured. Methylprednisolone and gentamicin were injected subconjunctivally, and the eye was closed for 24 hours. The following day the eye was quiet with a visual acuity of 6/9 and the subsequent course was uneventful.After a LASIK procedure the flap adheres to the corneal stroma because of the action of the endothelial pump and because the epithelium grows over the flap's margin. Scarring and fibrosis occur only at the flap's margin.1 Early and late complications are mainly haloes, glare, star-burst and dry eye. A dreaded complication is corneal ectasia. 2Traumatic dislocation has been reported after 10 days, 3 1 year 4 and 3 years and 5 months. 5 Our report is the first to indicate the possibility of weak adhesion of the flap after a much longer time, i.e. 13 years. 2. Piccoli P, Gomes AAC, Piccoli FVA. Corneal ectasia detected 32 months after LASIK for correction of myopia and asymmetric astigmatism.

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Late traumatic LASIK flap loss during contact sport

Cited by 23 publications

References 15 publications

Visual acuity recovery after late traumatic femtosecond laser in situ keratomileusis flap loss

Visual acuity recovery after late traumatic femtosecond laser in situ keratomileusis flap loss

Surface ablation techniques

Partial flap avulsion following refractive surgery

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