Case Reports

Corneal flap replacement 48 hours after traumatic flap amputation in a patient with previous laser-assisted in situ keratomileusis (LASIK) 18 years ago

Case Report Details

First Author: S.Martin Nalda SPAIN

Co Author(s):    M. Berges   L. Bisbe   J. Puig   B. Azarfane   E. Kirkegaard   R. Falah     

Abstract Details

Purpose:

To describe a case of a patient with a traumatic right eye corneal flap amputation because of a blunt trauma and it replacement two days later.

Setting:

Corneal and ocular surface section Vall d´Hebron Hospital. Barcelona

Report of Case:

To report the case of a 38-year-old man who came to our hospital because of a blunt trauma to his right eye while working. The patient had undergone LASIK surgery 18 years ago. On examination, the amputated corneal flap was observed in the lower conjunctival fornix and it was kept in a recipient with balanced salt solution (BSS) and antibiotic (gentamicin). He also had a traumatic cataract, mydriasis and a big scleral laceration. The patient underwent surgery under general anesthesia the same day and the scleral laceration was sutured but not the corneal flap because the ophthalmologist was not a cornea specialist. Two days later the patient went to the operating room again and underwent removal of debris and epithelial ingrowth, irrigation of the stromal bed with BSS and application of mitomycin- C (MMC) 0,01% for 1 minute. The corneal flap was in good condition without necrosis and was sutured with 4 interrupted 10-0 nylon sutures and a bandage contact lens was replaced (video). The patient was given ofloxacin every 6 hours and dexametasone every 2 hours with good anatomical results.

Conclusion/Take Home Message:

The corneal flap can be repositioned with good results even hours after the trauma. It is recommended to remove properly the remains of the interface and epithelial growth and apply MMC 0,01% for 1 minute in order to reduce haze.

Financial Disclosure:

... gains financially from competing product or procedure, ... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, ... receives non-monetary benefits from a company producing, developing or supplying the product or procedure presented, ... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, ... is employed by a competing company, ... has significant investment interest in a company producing, developing or supplying product or procedure presented