Accidental self-removal of a flap - A rare complication of laser in situ keratomileusis surgery

PURPOSE: To report a rare complication in which the patient accidentally re moved the laser in situ keratomileusis corneal flap. METHODS: Interventional case report. A 35-year-old woman underwent uncompli cated laser in situ keratomileusis surgery. Ten days after surgery, she ins erted a soft contact lens into the right eye to improve her vision. She tri ed to remove the contact lens, but had pain and bleeding. She was referred 10 days later with a diagnosis of loss of flap. RESULTS: On examination, she had a best-corrected visual acuity of 20/70 in the right eye. The right eye examination revealed no corneal flap, mild co rneal edema, and significant haze. A central epithelial defect was found. CONCLUSION: Accidental corneal flap removal can rarely follow laser in situ keratomileusis surgery. This complication provides insight into the weak a dhesion of the flap onto the stromal bed after laser in situ keratomileusis surgery and, hence, the inherent risk of traumatic flap dislocation or amp utation, which needs to be explained to the patient. (C) 2001 by Elsevier S cience Inc. All rights reserved.