Late traumatic dislocation of laser in situ keratomileusis corneal flags

Purpose: To report the management and outcome of late-onset traumatic dislocation of laser in situ keratomileusis (LASIK) flaps. Design: Retrospective, observational case series. Participants: Four patients with late-onset LASIK flap dislocation occurring after mechanical trauma at various intervals (10 days-2 months) after the procedure. Intervention: In all cases of postoperative traumatic LASIK flap dislocation, the flap was refloated with scraping and irrigation of the underlying stroma[ bed within 12 hours of the injury. A bandage contact lens was placed, and a regimen including topical antibiotics and corticosteroids was instituted in all cases. Main Outcome Measures: Best spectacle-corrected visual acuity and complications associated with the surgery were monitored. Results: Postoperative follow-up ranged from 4 to 21 months. Nonprogressive epithelial ingrowth was noted in one patient and diffuse lamellar keratitis developed in another patient. All patients recovered pretrauma spectacle-corrected visual acuity. Conclusions: Corneal LASIK flaps are prone to mechanical dislocation as late as 2 months after the procedure. Appropriate management results in recovery of optimal visual outcomes. (C) 2000 by the American Academy of Ophthalmology.