Lasik Flap Perforation And Displacement Caused By Bird Bite - A Case Report

Published 2023 - 41st Congress of the ESCRS

Reference: PP09.17 | DOI: 10.82333/r2kt-xh05

Authors: Liyi Chiu* ¹ , Shiuhliang Hsu ¹

¹Ophthalmology,Kaohsiung Medical University Hospital ,Kaohsiung ,Taiwan, Province of China

Flap dislocation is one of the most severe post LASIK operation complications. The risk factors of flap dislocation include excessive lid squeezing, eye rubbing, epithelial abrasion, and trauma. We present a case of traumatic LASIK flap displacement and full flap layer penetration by bird bite 14 years after LASIK operation. According to our knowledge, this is the first reported case of bird bite related LASIK flap displacement.

It's a case presenation of a special case refered from a local medical doctor to our medical center. We have informed consent from the patient.

t’s a retrospective case report. We collect patient’s visual acuity, intra-ocular pressure, slit lamp examination photos and corneal optical coherence tomography results before and after flap replacement

A 40-year-old female came to our outpatient department for help due to left eye irritation and blurry for 1 week. She had bird bite incident 1 week ago. On presentation, LASIK flap displacement with edge irregular from 12 to 4 o’clock and multiple white dot depositions over interface approaching visual axis was observed. One small flap perforation hole about 0.1 mm in size was also noted. The vision of afffected eye decreased to 0.4 Snellen chart and the OCT showed LASIK interface hyperreflective signals with one full flap layer penetration hole. We perform flap reposition for the patient and twice corneal YAG lasers afterward to inhibit epithelium islands ingrowth. After sequential treatment. The patient’s vision in left eye improved 0.9.

The flap dislocation may be caused from sport related activities, work related accidents, animal injuries and even after failure of airbags during car accidents. It is important that all patients undergoing LASIK should be aware of the persistent vulnerability of the flap. During flap reposition, all doreign bodies, epithelial sliding and debris should be scraped off the interface then thoroughly irrigation. Patients may have well visual acuity after operation if the flap displacement is managed appropriately.