Non-traumatic bilateral corneal flap dislocation 20 years after LASIK.

BACKGROUD: This report describes a case of late non-traumatic dislocation of bilateral corneal flaps, occurring 20 years after LASIK surgery.

CASE PRESENTATION: A 52-year-old woman underwent LASIK surgery on both eyes 20 years ago. She visited our clinic with sudden visual loss and denied any history of trauma. Eye examination revealed bilateral corneal flap dislocation. The right flap was hinged temporally and the left flap nasally. The left corneal flap showed tractional deformation, neovascularization, and proliferative membrane formation at the hinge area. Immediate corneal flap replacement surgery was performed on both eyes, and a bandage lens was applied. Six weeks after the surgery, Anterior Segment Optical Coherence Tomography (AS-OCT) showed that the corneal flap was centered, without displacement, and exhibited epithelial ingrowth. The uncorrected distance visual acuity was 20/40 OU.

CONCLUSION

This extraordinary case underscores a remarkable occurrence of bilateral corneal flap displacement, attributed to non-traumatic factors. The potential association between dry eye conditions, not solely as a risk factor but also as a potential direct causative agent for flap dislocation.