Late-Onset Flap Complications After Ocular Trauma In A Patient Previously Treated With Femto Laser In Situ Keratomileusis (Lasik): Diagnosis And Management.

To describe the management and the outcome of traumatic, flap-related complications in a patient that underwent Femto LASIK surgery 10 years ago.

LMVision, Laser and Microsurgery Ocular Day Clinic, Thessaloniki, Greece

A 36-year-old male presented to our clinic with complaints of foreign body sensation and decreased vision in his left eye following ocular trauma with a baby fingertip sustained 12 days earlier. He first visited a tertiary hospital ophthalmic emergency department, where he was misdiagnosed as corneal erosion and was treated accordingly. Anterior segment optical coherence tomography (OCT) and slit-lamp examination revealed a centrally dislocated LASIK flap with its superotemporal edge folded inwards, epithelial ingrowth both under the folded edge and the whole flap and diffuse lamellar keratitis centrally. We attempted flap repositioning, careful removal of epithelium, scraping of epithelial ingrowth and debris and also addressed the flap fold and striae. A bandage contact lens was placed. The patient’s following topical treatment included steroids, antibiotics and artificial tears. Visual acuity improved to 6/5 and was maintained at that level.

Patients should be appropriately warned of the possibility of late traumatic flap displacement during lifetime. Visual recovery is possible if the dislocation is promptly diagnosed and appropriately managed.