Unusual presentation of corneal laceration in a post-LASIK eye following blunt trauma

PURPOSE: To report a case with full thickness corneal laceration behind the intact LASIK flap after blunt trauma. OBSERVATIONS: A 48-year-old man with a history of LASIK surgery was hit by a shovel. Slit-lamp examination showed 4+ corneal edema. The anterior chamber (AC) was deep and the Seidel test was negative. Uncorrected distance visual acuity (UDVA) was hand motion. A more accurate evaluation was performed with an anterior segment optical coherence tomography (OCT) and it was found that the paracentral corneal tissue was ruptured while the flap remained completely intact. Under the surgical procedure, the rupture site was sutured, and then the flap was replaced, and two U-shaped sutures were performed to ensure the flap stability. Three months after surgery, corrected distance visual acuity (CDVA) was 9/10 decimal with a manifest refraction of +1–3 x 60°. CONCLUSIONS AND IMPORTANCE: In a traumatic post-LASIK eye, the posterior part of the flap should be carefully evaluated. The role of the OCT device in the diagnosis and management of complication is also very valuable.