Three years and 5 months after uneventful laser in situ keratomileusis, the left eye of a 39-year-old man was struck by the finger of a friend while the two were practicing karate, resulting in loss of the flap. The patient had performed this contact sport regularly for years. When last seen 16 weeks after injury, the best corrected visual acuity in the left eye was 20/40 with -1.75 -0.50x30. Mild central corneal haze was observed under slitlamp examination, the flap was missing, and the patient complained of dysphotopsia. Pachymetry in the left eye was 394 mum, with an irregular corneal contour. Flap loss is a serious complication because severe irregular astigmatism and unpredictable refractive change can occur. This case highlights the vulnerability of flaps to trauma even late postoperatively.
Blood flow, arterial velocity, and vascular diameter were measured in patients with retinal vessel occlusion before and after treatment, especially after light coagulation. The mean values in the patient group showed significantly reduced blood flow and velocity compared to the normal group. The mean group difference before and after therapy revealed that while there is an increase in blood flow after treatment, the normal value is not reached. Individual patient values indicated both increased and decreased blood flow and velocity after treatment as compared with the values before therapy. There are various stages in microcirculatory disease and the microcirculation also behaves differently after treatment, which could be observed by measurement in vivo of the physiological flow parameters.
In seven diabetics of type 1 and seven of type 2, the flow physiologic magnitudes were measured in a retinal quadrant before and after photocoagulation. The segmental blood flow, the arterial flow velocity, and the diameters of artery and vein are smaller after photocoagulation than before. Investigations into the time course of the flow-physiologic parameters following photocoagulation show that the flow-physiologic values are stationary about 2 weeks after photocoagulation.
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