Aldave Anthony J, Hollander David A, Abbott Richard L
Department of Ophthalmology, The University of California-San Francisco, San Francisco, California, U.S.A.
Cornea. 2002 Aug;21(6):604-7. doi: 10.1097/00003226-200208000-00015.
To report a case of traumatic flap partial dislocation and subsequent diffuse lamellar inflammation 14 months after laser in situ keratomileusis (LASIK) retreatment.
Case report of a late flap dislocation that occurred during routine recreational activity (struck with a finger in the right eye while playing basketball).
The partially dislocated LASIK flap was reflected nasally, and the stromal surfaces of the flap and bed were thoroughly scraped to remove debris and epithelial cells. The flap was repositioned, and a bandage contact lens was placed. Diffuse lamellar inflammation, which developed on post-trauma day number two, was successfully treated with frequent topical steroids. Three weeks after the injury, the patient had regained 20/20 uncorrected visual acuity.
Patients should be appropriately warned of the possibility of late flap dislocation with traumatic forces encountered during routine recreational activities. Full visual recovery is possible if the dislocation is promptly diagnosed and appropriately managed.
报告一例准分子原位角膜磨镶术(LASIK)再次手术后14个月出现外伤性瓣片部分脱位及随后弥漫性板层角膜炎的病例。
报告一例在日常娱乐活动中发生的晚期瓣片脱位病例(打篮球时右眼被手指击中)。
部分脱位的LASIK瓣片向鼻侧翻转,对瓣片和植床的基质面进行彻底刮擦以清除碎屑和上皮细胞。瓣片重新复位,并佩戴绷带式隐形眼镜。外伤后第二天出现的弥漫性板层角膜炎经频繁局部应用类固醇成功治疗。受伤三周后,患者未矫正视力恢复至20/20。
应适当警告患者,在日常娱乐活动中遭受外力时可能发生晚期瓣片脱位。如果脱位能及时诊断并得到妥善处理,视力有可能完全恢复。