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Late LASIK flap dislocation can be safely managed

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TORONTO — LASIK flaps are vulnerable to traumatic dehiscence and dislocation even up to 2 years postoperatively. These episodes can be managed safely, surgeons here said.

David Rootman, MD, and colleagues reported two cases of late-onset flap dislocation after ocular trauma 7 and 26 months following LASIK surgery.

Both patients were managed with flap lifting, stretching and repositioning after irrigation and scraping of the stromal bed and underside of the flap.

In one patient, the dislocated flap was repositioned 4 hours after the trauma and a bandage contact lens was applied. That patient recovered uncorrected visual acuity (UCVA) of 20/20 1 week after the procedure. Another patient, who was managed 48 hours after the trauma, required repeat flap repositioning at 10 and 24 days after the initial procedure for treatment of persistent folds and striae in the visual axis. His UCVA 2 weeks after the third repositioning was 20/40 +2. Both patients developed diffuse lamellar keratitis that resolved with the use of topical corticosteroids.

The study is published in the January issue of Cornea.