[Cases of eye trauma after laser keratomileusis]

Variants of corneal injuries and their complications in various periods after laser keratomileusis are described. The causes and probable mechanisms of injuries are analyzed with consideration for pathohistological findings. A total of 3507 operations were performed in 1796 patients with myopia of 1.5-14.5 diopters. Hansatome microkeratotome was used for lamellar section of the cornea and EC 500 eximer laser (Nidek) for laser keratoablation. According to the consultation rate, the incidence of injuries was 0.45% (16 eyes). The injuries occurred 1 week to 6 months after the operation and were as follows: epithelial injuries (10 cases), foreign bodies in the cornea (4 cases), and displacement of corneal flap (2 cases). The causes of injuries were mainly communal, the outcomes were favorable, microsurgical reoperation was needed in 3 cases. The mechanisms of injuries were analyzed with consideration for the histology of human cornea. The most complete fixation of corneal flap after laser keratomileusis was attained in the wound channel and at the site of the flap stromal apposition. Mechanical displacement of the corneal flap resultant from the injury is the most probable during the 4-week formation of cicatricial tissue in the wound; later the direction of the traumatic agent is significant. Prevention of corneal injuries after laser keratomileusis is important.