Late-onset Traumatic Dislocation With Central Tissue Loss of Laser In Situ Keratomileusis Flap

PURPOSE: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 en...

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Veröffentlicht in:	Cornea 2006-10, Vol.25 (9), p.1107-1110
Hauptverfasser:	Pereira, Carlindo da Reitz, Narvaez, Julio, King, Julie A, Seery, Loren S, Gimbel, Howard V
Format:	Artikel
Sprache:	eng
Schlagworte:	Adult Corneal Stroma - injuries Corneal Topography Eye Injuries - etiology Eye Injuries - surgery Female Glucocorticoids - therapeutic use Humans Keratitis - drug therapy Keratitis - etiology Keratomileusis, Laser In Situ Reoperation Surgical Flaps Surgical Wound Dehiscence - etiology Surgical Wound Dehiscence - surgery Suture Techniques Wounds, Nonpenetrating - etiology Wounds, Nonpenetrating - surgery
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container_end_page	1110
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creator	Pereira, Carlindo da Reitz Narvaez, Julio King, Julie A Seery, Loren S Gimbel, Howard V
description	PURPOSE: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. CONCLUSION: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.
doi_str_mv	10.1097/01.ico.0000225709.77759.da
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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. CONCLUSION: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.</description><identifier>ISSN: 0277-3740</identifier><identifier>EISSN: 1536-4798</identifier><identifier>DOI: 10.1097/01.ico.0000225709.77759.da</identifier><identifier>PMID: 17133066</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adult ; Corneal Stroma - injuries ; Corneal Topography ; Eye Injuries - etiology ; Eye Injuries - surgery ; Female ; Glucocorticoids - therapeutic use ; Humans ; Keratitis - drug therapy ; Keratitis - etiology ; Keratomileusis, Laser In Situ ; Reoperation ; Surgical Flaps ; Surgical Wound Dehiscence - etiology ; Surgical Wound Dehiscence - surgery ; Suture Techniques ; Wounds, Nonpenetrating - etiology ; Wounds, Nonpenetrating - surgery</subject><ispartof>Cornea, 2006-10, Vol.25 (9), p.1107-1110</ispartof><rights>Copyright © 2006 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3624-beee3344f88f15c230ab2c71bfd1efd3a2394a4750d03a545094e41aeff279413</citedby><cites>FETCH-LOGICAL-c3624-beee3344f88f15c230ab2c71bfd1efd3a2394a4750d03a545094e41aeff279413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17133066$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pereira, Carlindo da Reitz</creatorcontrib><creatorcontrib>Narvaez, Julio</creatorcontrib><creatorcontrib>King, Julie A</creatorcontrib><creatorcontrib>Seery, Loren S</creatorcontrib><creatorcontrib>Gimbel, Howard V</creatorcontrib><title>Late-onset Traumatic Dislocation With Central Tissue Loss of Laser In Situ Keratomileusis Flap</title><title>Cornea</title><addtitle>Cornea</addtitle><description>PURPOSE: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. CONCLUSION: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.</description><subject>Adult</subject><subject>Corneal Stroma - injuries</subject><subject>Corneal Topography</subject><subject>Eye Injuries - etiology</subject><subject>Eye Injuries - surgery</subject><subject>Female</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Humans</subject><subject>Keratitis - drug therapy</subject><subject>Keratitis - etiology</subject><subject>Keratomileusis, Laser In Situ</subject><subject>Reoperation</subject><subject>Surgical Flaps</subject><subject>Surgical Wound Dehiscence - etiology</subject><subject>Surgical Wound Dehiscence - surgery</subject><subject>Suture Techniques</subject><subject>Wounds, Nonpenetrating - etiology</subject><subject>Wounds, Nonpenetrating - surgery</subject><issn>0277-3740</issn><issn>1536-4798</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkE1v1DAQhi1ERbeFv4AsDtwS_JV4ww0t9ENE6oFF3LBmk7HW4MSL7aji39fbXam-2CM9M-_4IeQDZzVnnf7EeO2GULNyhGg062qtddPVI7wiK97ItlK6W78mKya0rqRW7JJcpfSn8Fq34g255JpLydp2RX73kLEKc8JMtxGWCbIb6FeXfBjKM8z0l8t7usE5R_B061JakPYhJRos7SFhpPcz_eHyQr9jhBwm53FJLtEbD4e35MKCT_jufF-Tnzfftpu7qn-4vd986atBtkJVO0SUUim7XlveDEIy2IlB850dOdpRgpCdAqUbNjIJjWpYp1BxQGuF7hSX1-Tjae4hhn8Lpmwmlwb0HmYMSzLtWjCmWFPAzydwiOUPEa05RDdB_G84M0e7hnFT7JoXu-bZrhmhNL8_pyy7CceX1rPOAqgT8Bh8xpj--uURo9kj-Lx_HimFaKuyS8uPVXUMUfIJzGGHGQ</recordid><startdate>200610</startdate><enddate>200610</enddate><creator>Pereira, Carlindo da Reitz</creator><creator>Narvaez, Julio</creator><creator>King, Julie A</creator><creator>Seery, Loren S</creator><creator>Gimbel, Howard V</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200610</creationdate><title>Late-onset Traumatic Dislocation With Central Tissue Loss of Laser In Situ Keratomileusis Flap</title><author>Pereira, Carlindo da Reitz ; Narvaez, Julio ; King, Julie A ; Seery, Loren S ; Gimbel, Howard V</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3624-beee3344f88f15c230ab2c71bfd1efd3a2394a4750d03a545094e41aeff279413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Corneal Stroma - injuries</topic><topic>Corneal Topography</topic><topic>Eye Injuries - etiology</topic><topic>Eye Injuries - surgery</topic><topic>Female</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Humans</topic><topic>Keratitis - drug therapy</topic><topic>Keratitis - etiology</topic><topic>Keratomileusis, Laser In Situ</topic><topic>Reoperation</topic><topic>Surgical Flaps</topic><topic>Surgical Wound Dehiscence - etiology</topic><topic>Surgical Wound Dehiscence - surgery</topic><topic>Suture Techniques</topic><topic>Wounds, Nonpenetrating - etiology</topic><topic>Wounds, Nonpenetrating - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pereira, Carlindo da Reitz</creatorcontrib><creatorcontrib>Narvaez, Julio</creatorcontrib><creatorcontrib>King, Julie A</creatorcontrib><creatorcontrib>Seery, Loren S</creatorcontrib><creatorcontrib>Gimbel, Howard V</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cornea</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pereira, Carlindo da Reitz</au><au>Narvaez, Julio</au><au>King, Julie A</au><au>Seery, Loren S</au><au>Gimbel, Howard V</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Late-onset Traumatic Dislocation With Central Tissue Loss of Laser In Situ Keratomileusis Flap</atitle><jtitle>Cornea</jtitle><addtitle>Cornea</addtitle><date>2006-10</date><risdate>2006</risdate><volume>25</volume><issue>9</issue><spage>1107</spage><epage>1110</epage><pages>1107-1110</pages><issn>0277-3740</issn><eissn>1536-4798</eissn><abstract>PURPOSE: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. CONCLUSION: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.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>17133066</pmid><doi>10.1097/01.ico.0000225709.77759.da</doi><tpages>4</tpages></addata></record>
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subjects	Adult Corneal Stroma - injuries Corneal Topography Eye Injuries - etiology Eye Injuries - surgery Female Glucocorticoids - therapeutic use Humans Keratitis - drug therapy Keratitis - etiology Keratomileusis, Laser In Situ Reoperation Surgical Flaps Surgical Wound Dehiscence - etiology Surgical Wound Dehiscence - surgery Suture Techniques Wounds, Nonpenetrating - etiology Wounds, Nonpenetrating - surgery
title	Late-onset Traumatic Dislocation With Central Tissue Loss of Laser In Situ Keratomileusis Flap
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