Pirhadi Shiva, Adnani Seyede-Yasamin, Jadidi Khosrow
Vision Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.
Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran.
Am J Ophthalmol Case Rep. 2022 Feb 10;26:101419. doi: 10.1016/j.ajoc.2022.101419. eCollection 2022 Jun.
To report a case with full thickness corneal laceration behind the intact LASIK flap after blunt trauma.
A 48-year-old man with a history of LASIK surgery was hit by a shovel. Slit-lamp examination showed 4+ corneal edema. The anterior chamber (AC) was deep and the Seidel test was negative. Uncorrected distance visual acuity (UDVA) was hand motion. A more accurate evaluation was performed with an anterior segment optical coherence tomography (OCT) and it was found that the paracentral corneal tissue was ruptured while the flap remained completely intact. Under the surgical procedure, the rupture site was sutured, and then the flap was replaced, and two U-shaped sutures were performed to ensure the flap stability. Three months after surgery, corrected distance visual acuity (CDVA) was 9/10 decimal with a manifest refraction of +1-3 x 60°.
In a traumatic post-LASIK eye, the posterior part of the flap should be carefully evaluated. The role of the OCT device in the diagnosis and management of complication is also very valuable.
报告1例钝挫伤后LASIK瓣完整但角膜全层撕裂的病例。
一名有LASIK手术史的48岁男性被铲子击中。裂隙灯检查显示角膜水肿4级。前房深，Seidel试验阴性。未矫正远视力（UDVA）为手动。采用眼前节光学相干断层扫描（OCT）进行了更准确的评估，发现角膜旁中央组织破裂，而瓣仍完全完整。手术过程中，对破裂部位进行缝合，然后复位瓣，并进行两根U形缝线以确保瓣的稳定性。术后3个月，矫正远视力（CDVA）为小数视力9/10，明显屈光不正为+1 - 3×60°。
在LASIK术后外伤眼中，应仔细评估瓣的后部。OCT设备在并发症的诊断和处理中也非常有价值。
