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Role of SD‐OCT in the diagnosis and management of a late‐onset corneal LASIK flap tear secondary to screwdriver trauma
Author(s) -
ESTEBAN O,
RODRIGUEZ NA,
ASCASO FJ,
SOLANAS S
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2014.s018.x
Subject(s) - medicine , lasik , surgery , cornea , dehiscence , complication , ophthalmology
Purpose Traumatic flap displacement is a known possible complication after LASIK. It occurs most commonly in the first 24 h following surgery in approximately 1%‐2% of cases. However, late flap dislocations have also been reported. We present a case of traumatic flap displacement occurring four years after the initial LASIK surgery. Methods Interventional case report showing the role of spectral domain optical coherence tomography (SD‐OCT) in the management of the LASIK flap dislocation. Results A 29‐year‐old man presented with blurred vision, photophobia, and pain after trauma to his left eye caused by a screwdriver. He had a history of moderate myopia and had undergone uneventful bilateral LASIK 10 years previously. On examination, he had a 180‐degree traumatic corneal flap dislocation with an inverted tear in the temporal cornea. We performed a precise exploration by SD‐OCT after repositioning the corneal flap and a disposable contact lens, used as a therapeutic bandage, was placed on the cornea. Topical antibiotics and glucocorticoids were administered. One month postoperatively, his previous visual acuity had recovered and the dislodged flap showed an epithelial ingrowth, which did not require removal. Conclusion Early recognition, precise control by SD‐OCT and reposition the flap along with hydrating the flap together with a contact lens, topical antibiotics and steroids may be a good treatment option. Late traumatic flap dehiscence is a rare complication which demonstrates the vulnerability the flap‐bed stromal interface how a potential zone of weakness for many years following the procedure. Patients should be advised to visit ophthalmologist for injury after LASIK.