title: Late-onset traumatic dislocation with central tissue loss of laser in situ keratomileusis flap.
abstract: OBJECTIVE
  We report the occurrence and outcome of a severe late-onset traumatic dislocation of a laser in situ keratomileusis (LASIK) flap with loss of central flap tissue.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 40-year-old woman underwent uncomplicated bilateral LASIK surgery, followed 5 years later by an enhancement procedure in both eyes. Ocular trauma with a power sander occurred 6 years after LASIK and 1 year after the enhancement procedure. The flap was found to have an almost complete tear from the nasal hinge and a central tissue defect. After irrigating, repositioning, and stabilizing the flap with 2 nylon sutures, a bandage contact lens was placed. The patient was treated with topical antibiotic and steroid drops. Stage 2 diffuse lamellar keratitis developed, which responded to topical treatment. Ten weeks after injury, the patient regained an uncorrected visual acuity of 20/20-1.
  
  
  CONCLUSIONS
  Late-onset trauma to the LASIK flap can result in flap dehiscence and tissue loss. Prompt and appropriate management can lead to an excellent visual outcome even in severely traumatized dislocated LASIK flaps.
authors.affiliation: Department of Ophthalmology, Loma Linda University, Loma Linda, CA 92354, USA. carlindo.pereira@med.va.gov
authors.forename: Carlindo da Reitz
authors.initials: Cda R
authors.lastname: Pereira
authors.forename: Julio
authors.initials: J
authors.lastname: Narvaez
authors.forename: Julie A
authors.initials: JA
authors.lastname: King
authors.forename: Loren S
authors.initials: LS
authors.lastname: Seery
authors.forename: Howard V
authors.initials: HV
authors.lastname: Gimbel
mesh_terms: D000328:Adult; D003319:Corneal Stroma / Q000293:injuries*; D019781:Corneal Topography; D005131:Eye Injuries / Q000209:etiology* / Q000601:surgery; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007634:Keratitis / Q000188:drug therapy / Q000209:etiology; D020731:Keratomileusis, Laser In Situ; D012086:Reoperation; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000601:surgery; D013536:Suture Techniques; D014949:Wounds, Nonpenetrating / Q000209:etiology* / Q000601:surgery
chemical_list: D005938:Glucocorticoids