JRS
Vol 22, May 2006
Late Traumatic Flap Dislocations After LASIK
http://www.journalofrefractivesurgery.c ... hing=12869
Excerpts from the full text:
A number of cases of late onset traumatic LASIK flap dislocations
have been reported, raising questions about the strength
of the adhesion between the flap and the stromal bed.
In this series, we report three cases of late onset traumatic
LASIK flap displacement and their management. One patient
presented 7 years after the initial surgery, which, to our
knowledge, is the longest duration reported.
A 23-year-old man with bilateral uncomplicated LASIK
7 years prior presented 2 days after sustaining a left eye injury
by another person?s fingernail in a fight.
A 33-year-old woman underwent LASIK and pre-
sented after sustaining a broomstick injury 1 year
postoperatively.
A 38-year-old woman with a history of uncomplicated
bilateral LASIK 2 years before sustained a right eye
injury when a folder fell from a shelf.
The creation of a lamellar flap results in a potential
plane of weakness in the cornea in which shearing
forces can produce flap displacement. Recent
histological and confocal studies have shown a central
hypocellular primitive scar in the interface, allowing
easy lifting of the flap in trauma.
The fact that this potential plane can be disrupted
many years after LASIK (7 years after the initial surgery
in patient 1) indicates that
corneal integrity is
compromised by the surgical procedure and takes a
long time, if ever, to restore.