|
|
21. Kongress der DGII 2007
Abstracts DGII 2007
KV 102
Late Postoperative Traumatic Flap Loss
Werner L1, Tetz MR1, Müller M1, Dietze U2
1Augentagesklinik Spreebogen, Berlin, 2Augenklinik Berlin-Marzahn
Purpose: Traumatic loss of a corneal flap is a serious complication because severe irregular astigmatism and unpredictable refractive change can occur. We describe the clinical course of a case of late postoperative LASIK flap loss occurring during contact sports.
Materials and Methods: The patient was a 39-year-old man with −7.50 – 0.25 × 42 (OD), and −7.25 – 0.50 × 164 (OS), for a best-corrected visual acuity (BCVA) of 20/20 OU. Pachymetry was 580 and 575 microns in OD and OS, respectively. Flaps with a superior hinge were cut before laser ablation. Eleven months later, BCVA was 20/20 in both eyes, with −0.50 × 15 (OD), and plano (OS). Three years later, OS was struck by the finger of a friend while practicing karate with the patient, with immediate decrease in visual acuity, and ocular pain.
Results: Upon examination, conjunctival hyperemia was observed, and the LASIK flap could not be found. The central 8.5 mm of the cornea were fluorescein positive. Initially, pachymetry measurement read 0.493 mm. The patient was treated with ofloxacin, artificial tears, and dexamethasone eye drops, and oral Vitamin C 1 g/day. A bandage contact lens was placed. The central cornea was completely re-epithelialized one week later. The outline of the stromal flap margins was visible. BCVA was 0.125 with −1.25 – 1.25 × 111 one week after injury. Pachymetry was 0.374 microns. Further changes in these parameters were observed 3 months after the injury.
Conclusion: This case demonstrates the vulnerability of flaps to trauma even late postoperatively.
Erschienen in: Klin Monatsbl Augenheilkd, 224, Suppl. 2 |