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Late-onset traumatic flap dislocation and diffuse lamellar inflammation after laser in situ keratomileusis
Anthony J Aldave1, David A Hollander, Richard L Abbott
1Department of Ophthalmology, The University of California-San Francisco, San Francisco, California, U.S.A. aaldave@pol.net
Purpose:
To report a case of traumatic flap partial dislocation and subsequent diffuse lamellar inflammation 14 months after laser in situ keratomileusis (LASIK) retreatment.
Methods:
Case report of a late flap dislocation that occurred during routine recreational activity (struck with a finger in the right eye while playing basketball).
Results:
The partially dislocated LASIK flap was reflected nasally, and the stromal surfaces of the flap and bed were thoroughly scraped to remove debris and epithelial cells. The flap was repositioned, and a bandage contact lens was placed. Diffuse lamellar inflammation, which developed on post-trauma day number two, was successfully treated with frequent topical steroids. Three weeks after the injury, the patient had regained 20/20 uncorrected visual acuity.
Conclusions:
Patients should be appropriately warned of the possibility of late flap dislocation with traumatic forces encountered during routine recreational activities. Full visual recovery is possible if the dislocation is promptly diagnosed and appropriately managed.