Late Traumatic Avulsion of a Femtosecond LASIK Flap Following a Direct Corneal Injury: A Case Report.
Daniel David, Guy Kleinmann, Samuel Levinger et al.
✦ AI-curated · Sources linked
Case in brief
A 34-year-old woman developed pain and reduced vision after a pet bird injured her left cornea, 10 months after uncomplicated femtosecond LASIK. Examination showed complete absence of the flap and a sharply defined circular epithelial defect matching its borders; the flap was not found on the ocular surface or in the fornices. With a bandage contact lens, fortified topical antibiotics, and subsequently adjusted topical anti-inflammatory treatment including losartan, the cornea reepithelialized. At 10 weeks, haze was minimal, visual symptoms had improved, and uncorrected distance acuity was 20/20 in each eye.
What made this case unusual
Direct trauma caused complete avulsion of a femtosecond LASIK flap 10 months after surgery, illustrating that the interface may remain vulnerable well beyond the immediate postoperative period.
Diagnostic / clinical pearl
After corneal trauma in a patient with prior LASIK, a sharply demarcated epithelial defect corresponding to the flap borders should prompt assessment for flap avulsion, even months after surgery.
Why it matters
Prompt recognition and management may help limit infection, stromal scarring, and lasting visual sequelae.