LASIK flap stability after severe ocular injury

Todd, Timothy; Mondzelewski, Todd; Cason, John B.; Hofmeister, Elizabeth M.; O’Connell, Stephen R; Richmond, Christopher J.

doi:10.1016/j.ajoc.2020.100608

Cited by 6 publications

(4 citation statements)

References 16 publications

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“…Despite reports of intact flaps after very violent corneal traumas, 10 in our series, dislocation or even avulsion could follow minor traumatic events with an adequate direction of the force, and only 2 cases were associated with sports (football and tennis).…”

Section: Discussioncontrasting

confidence: 62%

Traumatic Flap Complications After Femtosecond LASIK

Leccisotti

Fields²,

Bartolo³

et al. 2021

Cornea

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The purpose of this article was to evaluate the prognosis of traumatic flap dislocation or avulsion in a large series of laserassisted in situ keratomileusis (LASIK) cases.Methods: Retrospective, consecutive, noncomparative case series analyzes the visual and anatomical results after flap dislocation or avulsion, caused by trauma occurred at least 1 month after LASIK.Results: A total of 37,315 eyes of 19,602 patients were reviewed. A traumatic flap complication was observed in 9 eyes of 9 patients, with a maximum interval of 37 months after surgery. Flap dislocation with central full-thickness folds was found in 5 cases; flap lifting and repositioning achieved a full recovery of uncorrected visual acuity. In another case, a partially detached flap was repositioned by a microsponge without lifting; self-limiting localized epithelial ingrowth followed. In 3 eyes, a complete flap avulsion occurred and, after epithelialization, a moderate refractive change was observed, comprised between 20.25 and 21 diopters (D) of spherical equivalent, with astigmatism ,1 D; in 1 eye, the resulting myopia was corrected by repeat femtosecond LASIK.Conclusions: Traumatic flap complications after femtosecond LASIK are rare but can occur even in the long term; they have a favorable anatomic and visual prognosis.

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Section: Discussioncontrasting

confidence: 62%

Traumatic Flap Complications After Femtosecond LASIK

Leccisotti

Fields²,

Bartolo³

et al. 2021

Cornea

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“…The incidence of ICL dislocation was 0.072%, suggesting that it is very rare. Studies have reported incidence rates of 0.085% and 0.012% for flap displacement due to trauma, a late postoperative complication of LASIK [ 21 , 22 ]; these rates are similar those of ICL dislocation.…”

Section: Discussionmentioning

confidence: 90%

Multicenter survey on implantable collamer lens dislocation

et al. 2022

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This study aimed to investigate the incidence, patient background, and postoperative prognosis of implantable collamer lens (ICL) dislocation. We retrospectively reviewed all cases of ICL dislocation at four major refractive surgery centers in Japan until December 2019. The incidence, patient background, cause of dislocation, complications of repositioning surgery, and postoperative visual function were investigated. Seven ICL dislocations [0.072% of total ICL-implanted eyes (9775 eyes)] occurred at an average of 28.6 months (11–82 months) postoperatively. All patients were male. Five eyes were injured during sports activities, one due to a fall from a bicycle, and another due to ocular blunt trauma caused by a mortuary tablet. Two patients had re-dislocation in the same eye. Retinal detachment occurred after repositioning surgery in one patient, and scleral buckling surgery was performed without ICL removal. ICL dislocation is a rare complication of ICL surgery; repositioning surgery is effective, but retinal complications may occur.

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“…LASIK flaps have shown tremendous stability during severe mechanical ocular trauma [ 7 ]. However, traumatic flap dislocation can still occur.…”

Section: Discussionmentioning

confidence: 99%

Traumatic displacement of laser in situ keratomileusis flaps: an integrated clinical case presentation

2021

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Background Traumatic dislocation of laser-assisted in situ keratomileusis (LASIK) corneal flaps is an uncommon postoperative complication that could occur any time after LASIK, and could be visually devastating. We evaluated the visual outcomes, corneal sensation, tear function, and dry eye questionnaire results of patients with traumatic dislocation of LASIK flaps, including one LASIK flap amputation. Methods This is a retrospective case series. Seven patients who were diagnosed with traumatic displacement of the LASIK flap and underwent flap replacement surgery between August 2014 and January 2019 were included.Patient’s visual acuity, refraction, corneal sensitivity, non-invasive tear breakup time (NIBUT), tear meniscus height (TMH), and ocular surface disease index (OSDI) results were evaluated. Results The patients’ mean age was 35.86 ± 5.84 years, and 42.9 % (3/7) were male. The mean duration from LASIK to trauma was 8.86 ± 2.48 years.The mean preoperative and postoperative six-month corrected distance visual acuity (CDVA) were 0.55 ± 0.34 and 0.02 ± 0.03, respectively. The mean spherical equivalent and astigmatism at six months postoperatively was − 1.0 ± 0.95 D and − 0.5 ± 0.25 D, respectively. The corneal flap was clear and well-positioned at the final follow-up (mean: 28.57 ± 6.9 months). 85.71 % (6/7) of the patients showed worse corneal sensation in the injured eye. Interocular OSDI discrepancy was less in those whose last visit was more than 30 months after the trauma. Conclusions Postoperative CDVAat six months was improved, and the refractive data also showed some improvement. The corneal nerve and tear function recovery peaked before 30 months, while the OSDI continued to show a strong trend of improvement beyond 30 months.

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LASIK flap stability after severe ocular injury

Cited by 6 publications

References 16 publications

Traumatic Flap Complications After Femtosecond LASIK

Traumatic Flap Complications After Femtosecond LASIK

Multicenter survey on implantable collamer lens dislocation

Traumatic displacement of laser in situ keratomileusis flaps: an integrated clinical case presentation

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