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Eye injury in a young male with history of refractive surgery: diagnostic approach and management

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Session Details

Session Title: Presented Poster Session: Miscellaneous and Infections

Venue: Poster Village: Pod 3

First Author: : T.Lalias GREECE

Co Author(s): :    E. Kanonidou              

Abstract Details

Purpose:

Refractive surgery is commonly practiced in ophthalmology nowdays and it would be sensible to consider such a parameter when treating ocular conditions. Our purpose is to present a case where an eye that had undergone refractive surgery was injured and the methodology used regarding diagnosis and treatment.

Setting:

Department of Ophthalmology, ''Hippokrateion'' General Hospital of Thessaloniki, Thessaloniki, Greece

Methods:

A 32 year old male presented with ocular injury after been hit at the RE by multiple foreign bodies (stones and dust). The patient was myopic and had undergone successful Femtosecond-assisted Lasik prosedure two years ago. Before the surgery his refraction was (-1,75sph -1,25 cyl x 180 RE/LE) and CCT RE :501μ, LE :506μ. He was free of any other ocular or systematic condition.

Results:

RE had lower eyelid trauma, corneal abrasion, intrastromal foreign bodies and iridoplegia. Fundus examination revealed choroidal rupture parapapillary (OCT confirmed) and two small haemorrhages inferiorly. BCVA was CF. B-scan exluded the presence of intraocular foreign bodies. Most of the foreign bodies were removed however some remained in the anterior stroma. Seven days later destruction of the flap from 4th to 6th hour was noticed. Three weeks later the corneal abrasion improved, however corneal melting of the flap with epithelial ingrowth was detected nasally. BCVA improved to 7/10. The patient was reviewed with pentacam topography and listed for reconstructive refractive surgery.

Conclusions:

In the above case a cornea which anatomy has been remodeled is more susceptible to injuries and that can have an effect to the rest of the eye. In addition healing may be more complex and time consuming in comparison to intact corneas. Sometimes dillemas can arise regarding the time of possible surgical treatment considering the kind the severity of the damage and the BCVA. In any case treatment should be customized accordingly.

Financial Disclosure:

NONE

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