CLC number: R779.62
On-line Access: 2017-06-05
Received: 2016-09-01
Revision Accepted: 2016-11-10
Crosschecked: 2017-05-10
Cited: 0
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Ye-sheng Xu, Wen-jia Xie, Yu-feng Yao. Satisfactory clinical outcome following delayed repositioning of a traumatic post-LASIK flap with dislocation and shrinkage managed by irrigation, stretching, and debridement[J]. Journal of Zhejiang University Science B, 2017, 18(6): 539-543.
@article{title="Satisfactory clinical outcome following delayed repositioning of a traumatic post-LASIK flap with dislocation and shrinkage managed by irrigation, stretching, and debridement",
author="Ye-sheng Xu, Wen-jia Xie, Yu-feng Yao",
journal="Journal of Zhejiang University Science B",
volume="18",
number="6",
pages="539-543",
year="2017",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1600363"
}
%0 Journal Article
%T Satisfactory clinical outcome following delayed repositioning of a traumatic post-LASIK flap with dislocation and shrinkage managed by irrigation, stretching, and debridement
%A Ye-sheng Xu
%A Wen-jia Xie
%A Yu-feng Yao
%J Journal of Zhejiang University SCIENCE B
%V 18
%N 6
%P 539-543
%@ 1673-1581
%D 2017
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1600363
TY - JOUR
T1 - Satisfactory clinical outcome following delayed repositioning of a traumatic post-LASIK flap with dislocation and shrinkage managed by irrigation, stretching, and debridement
A1 - Ye-sheng Xu
A1 - Wen-jia Xie
A1 - Yu-feng Yao
J0 - Journal of Zhejiang University Science B
VL - 18
IS - 6
SP - 539
EP - 543
%@ 1673-1581
Y1 - 2017
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1600363
Abstract: Objective: To report surgical management and favorable outcome in a case with delayed repair of traumatic laser in situ keratomileusis (LASIK) flap dislocation with shrinkage and folds. Methods: A 30-year-old man with a five-year history of bilateral LASIK experienced blunt trauma to his right eye followed by decreased vision for 5 weeks. The surgical management included initially softening the flap by irrigation with balanced salt solution (BSS). The shrinkage folds were carefully and gently stretched by scraping with a 26-gauge cannula accompanied by BSS irrigation. All of the epithelial ingrowth on the flap inner surface and on the bed was thoroughly debrided by scraping and irrigation. After the flap was repositioned to match its original margin, a soft bandage contact lens was placed. Results: At his initial visit, slit-lamp microscopy and optical coherence tomography (OCT) showed shrinkage of the LASIK flap with an elevated margin approximately 3 mm above the original position. The flap covered half of the pupil and had multiple horizontal folds. Two months after surgery, the flap remained well positioned with only faint streaks in the anterior stroma. The uncorrected visual acuity of the right eye was 20/20 with a manifest refraction of Plano. Conclusions: For delayed repair of traumatically dislocated LASIK flaps, sufficient softening by BSS, stretching the shrinkage folds, and thorough debridement of ingrowth epithelium enable resetting the flap and provide satisfactory results.
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