Partial dislocation of laser in situ keratomileusis flap by air bag injury

PURPOSE: A patient developed significant corneal complications from air bag deployment, 17 months after laser in situ keratomileusis (LASIK), METHODS: Case report, slit-lamp microscopy, and review of the medical liter ature. RESULTS: A 37-year-old woman underwent bilateral LASIK with resultant 20/20 uncorrected visual acuity, Seventeen months later, she sustained facial an d ocular injuries from air bag deployment during a motor vehicle accident, Examination revealed bilateral corneal abrasions, partial dislocation of th e right corneal LASIK flap, and a hyphema in the right eye. The LASIK flap was realigned, but recovery was complicated by a slowly healing epithelial defect and flap edema. One month following the injury, epithelial ingrowth beneath the LASIK: Bap was noted, Surgical elevation of the flap and remova l of the epithelial ingrowth was performed. Eight months later, epithelial ingrowth was absent and the visual acuity was 20/40. Residual irregular ast igmatism necessitated rigid gas permeable contact lens fitting to achieve 2 0/20 visual acuity, CONCLUSIONS: Air bags may cause significant ocular trauma. The wound healin g response of LASIK allows corneal flap separation from its stromal bed for an indeterminate time after surgery. Discussion of the possible risk of co rneal trauma as part of informed consent prior to LASIK may be appropriate.