Case Reports

Airbag trauma and a temporary corneal ectasia

Case Report Details

First Author: A.Marta PORTUGAL

Co Author(s):    A. Marta   A. Abreu   S. Monteiro   M. Pinto           

Abstract Details

Purpose:

To report a case of a temporary corneal ectasia induced by airbag trauma. Case report of a patient candidate to refractive surgery Tomographic parameters were evaluated with Oculus Pentacam® HR during three different observations: first observation (1E), second observation (2E) 12 months later 1E or 3 months after airbag trauma, and third observation (3E) 6 months after 2E or 9 months after airbag trauma.

Setting:

This clinical case was followed at ophthalmology department of a tertiary referral centre in Oporto, Portugal - Centro Hospitalar Universitário do Porto.

Report of Case:

A 36‐year‐old male was referenced to our hospital for refractive surgery. He was otherwise healthy with no familiar or medical history. At 1E Best Corrected Visual Acuity was 20/20 with -2.00 diopters (D) in the right eye (RE) and 20/20 with -2.25-0.25x30o D in the left eye (LE) and remained stable throughout following observations. At 1E, Oculus Pentacam® HR parameters were globally normal. However, at 2E, 3 months after an airbag trauma, we observed the following alterations: TP changed from 530um (1E) to 376um (2E) in the RE and from 502um (1E) to 486um (2E) in the LE; the ARTmax from 415um (1E) to 127um (2E) in the RE and from 346 (1E) to 291 (2E); final “D” value of BAD changed from 0.71 (1E) to 4.93 (2E) in the RE and from 1.15 (1E) to 1.84 (2E) in the LE. At 3E we observed a normalization of the former parameters: TP 519um in the RE and 515um in the LE; ARTmax 461um in the RE and 420 in the LE; “D” value of BAD-D of 0.39 in the RE and 0.81 in the LE. The topometric indices remained stable, except for the increase of the Index of Height Decentration and Index of Height Asymmetry at 2E, which normalized at 3E, in the RE. The aberrometric indices also remained stable, except for the increase of the Root Mean Square (RMS) and RMS of Higher Order Aberrations at 2E, which normalized at 3E, in the RE.

Conclusion/Take Home Message:

Literature reports about ocular injuries caused by airbag’s trauma, including dislocation flaps or folds in patients with previous refractive surgery and, recently, corneal ectasia development in post-refractive or virgin corneas exist. However, the possibility of reversibility of corneal ectasias in this context was never reported. Our clinical case may be explained by the viscoelastic properties of cornea. In this clinical case, the external shear forces induced by airbag may have not been enough to cause a permanent corneal ectasia, and the viscoelastic or memory properties may have had a role in the recovery of the corneal parameters. Also, it is important to highlight the fact that our patient had not undergone refractive surgery prior to the trauma. The good structural integrity of the cornea may help to explain the recovery seen this case, compared to other cases reported in the literature.

Financial Disclosure:

None