Management of traumatic displacement of LASIK flap

Abstract

Background: Although flap-based laser refractive surgeries are being extensively performed worldwide, complications due to the flap may occur years after the procedure leading to severe vision-threatening complications. Purpose: To describe the management of a case of traumatic displacement of a LASIK flap performed 8 years earlier. Synopsis: A 42-year-old male presented to us with complaints of decreased vision in his left eye following trauma with a toy gun sustained a day earlier. His best-corrected visual acuity was Counting fingers @ 2 m, and a slit-lamp evaluation revealed a LASIK flap with its temporal edge folded inwards. Flap repositioning was planned. The final surgical plan was interface irrigation with mechanical debridement, alcohol epitheliectomy, fibrin glue application, and bandage contact lens. His uncorrected visual acuity improved to 6/6, N6 at 5 weeks postoperatively, which was maintained at 8 months postoperatively along with a clear interface. Highlights: Traumatic displacement of LASIK flap years after the procedure is a known complication. However, simple flap repositioning may lead to various complications like epithelial ingrowth, DLK, astigmatism, etc., This video describes how to achieve anatomical and visual rehabilitation in such eyes without any long-term complications. Video link: https://youtu.be/QtWG9hEMsXM

Keywords

• epithelial ingrowth
• lasik flap complications
• traumatic flap displacement