Late-onset repetitive traumatic flap folds and partial dehiscence of flap edge after laser in situ keratomileusis

Abstract

A 25-year-old woman had traumatic flap folds and partial dehiscence of the flap edge in the right eye 5 and 30 months after laser in situ keratomileusis. The period from injury to treatment was 4 hours and 9 days, respectively. With the first injury, the flap was lifted and stretched with moistened sponges to clear the folds. With the second injury, the folds were hard so the flap was lifted and sutured to stretch the folds. The patient recovered visual acuity within 2 weeks.

Visual acuity recovery after late traumatic femtosecond laser in situ keratomileusis flap loss

“…Flap dislocations have resulted from atraumatic causes, 8 fingernail injuries, [9][10][11] sports injuries, 12 direct blunt trauma, 13,14 and air-bag injuries, 15,16 among others. Laceration of a LASIK flap with timely repair has been reported and resulted in a best corrected visual acuity (BCVA) of 20/20.…”

Treatment of Lost Flaps and Slipped Flaps

“…However, there have been case reports of successful recovery of 20/20 visual acuity following repair from two days to six weeks. 20,23,24,[27][28][29]35,38,39,41,44 Striae that extend through the visual axis cause a decrease in BSCVA or create irregular astigmatism as determined by manual keratometry or computerized topography should definitely be treated surgically. 51 If macrostriae are present for more than 24 hours, some surgeons recommend debriding the central 4 mm of epithelium before raising the flap to remove the scaffolding that may maintain the striae.…”