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Flap amputation for long-standing post-LASIK flap dislocation with epithelial ingrowth.

Sridevi Nair1, Manpreet Kaur1, Aafreen Bari1

  • 1Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

BMJ Case Reports
|February 9, 2022
PubMed
Summary

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A traumatic eye injury caused a LASIK flap dislocation and epithelial ingrowth. Surgical flap amputation and removal successfully restored vision, preventing further complications like corneal ectasia.

Area of Science:

  • Ophthalmology
  • Corneal Surgery

Background:

  • Laser-assisted in situ keratomileusis (LASIK) is a common refractive surgery.
  • Complications such as flap dislocation and epithelial ingrowth can occur post-LASIK, especially after trauma.

Observation:

  • A 26-year-old male presented with vision loss in his right eye one year after a fist injury.
  • He had a history of bilateral LASIK surgery five years prior.
  • Examination revealed a superotemporal LASIK flap dislocation with epithelial ingrowth obscuring the pupil and fixed flap folds.

Findings:

  • The patient underwent flap amputation and epithelial ingrowth removal, with 0.02% mitomycin C as an adjunct.
  • Postoperative uncorrected distance visual acuity (UDVA) improved from 1.0 logMAR to 0.3 logMAR on day 1, and 0.2 logMAR by one week.
Keywords:
eyetrauma

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  • At one year, UDVA was 0.2 logMAR, improving to 0.1 logMAR with refraction, with minimal corneal haze and no signs of corneal ectasia.

    • Implications:

    • Flap amputation and debridement can be an effective treatment for long-standing LASIK flap complications following trauma.
    • This approach can successfully restore visual acuity and prevent serious sequelae like corneal ectasia.
    • Mitomycin C may serve as a useful adjunct in managing epithelial ingrowth during such procedures.