Partial dislocation of laser in situ keratomileusis flap by air bag injury.
OBJECTIVE
A patient developed significant corneal complications from air bag deployment, 17 months after laser in situ keratomileusis (LASIK).


METHODS
Case report, slit-lamp microscopy, and review of the medical literature.


RESULTS
A 37-year-old woman underwent bilateral LASIK with resultant 20/20 uncorrected visual acuity. Seventeen months later, she sustained facial and ocular injuries from air bag deployment during a motor vehicle accident. Examination revealed bilateral corneal abrasions, partial dislocation of the right corneal LASIK flap, and a hyphema in the right eye. The LASIK flap was realigned, but recovery was complicated by a slowly healing epithelial defect and flap edema. One month following the injury, epithelial ingrowth beneath the LASIK flap was noted. Surgical elevation of the flap and removal of the epithelial ingrowth was performed. Eight months later, epithelial ingrowth was absent and the visual acuity was 20/40. Residual irregular astigmatism necessitated rigid gas permeable contact lens fitting to achieve 20/20 visual acuity.


CONCLUSIONS
Air bags may cause significant ocular trauma. The wound healing response of LASIK allows corneal flap separation from its stromal bed for an indeterminate time after surgery. Discussion of the possible risk of corneal trauma as part of informed consent prior to LASIK may be appropriate.
Lemley
H L
HL
Department of Ophthalmology, Dean A. McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
Chodosh
J
J
Wolf
T C
TC
Bogie
C P
CP
Hawkins
T C
TC
D000063:Accidents, Traffic; D000328:Adult; D017278:Air Bags / Q000009:adverse effects*; D003315:Cornea / Q000473:pathology / Q000601:surgery; D065306:Corneal Injuries; D005131:Eye Injuries / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D005151:Facial Injuries / Q000209:etiology / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D006988:Hyphema / Q000209:etiology / Q000473:pathology / Q000601:surgery; D020731:Keratomileusis, Laser In Situ; D009216:Myopia / Q000601:surgery; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D014792:Visual Acuity; D014949:Wounds, Nonpenetrating / Q000209:etiology* / Q000473:pathology / Q000601:surgery