This report describes a case of Scheimpflug topography oriented adequate repositioning of a misaligned thick free flap after laser in situ keratomileusis (LASIK). A 24-year-old patient consulted for irregular astigmatism and disoriented free right eye flap. The patient previously underwent binocular LASIK at a private clinic. During the right eye surgery, the flap was repositioned after laser ablation due to the free flap. The free flap was not repositioned to its original configuration due to insufficient preoperative corneal marking. On examination, the uncorrected visual acuity was 0.4, and refractive power was +2.00 Dsph with −4.25 Dcyl axis 66 in the right eye. Scheimpflug topography revealed irregular right eye astigmatism. The sagittal curvature of topography showed a 40° counterclockwise misalignment of the steep axis of the cornea. The free flap was repositioned by 40° clockwise rotation. After this, the refractive corneal power improved to −1.00 Dsph with −1.00 Dcyl Axis 19 in the right eye. The uncorrected and best-corrected visual acuity improved to 20/30 and 20/25 (x − 0.25Dsph −1.25 Dcyl A20), respectively. This is the first report on free flap repositioning using Scheimpflug topography. As proper flap positioning was compromised because of the free LASIK flap with no preoperative corneal marking, the flap was effectively repositioned using Scheimpflug topography.
Case Rep Ophthalmol 2021;12:889–893

中文翻译：

---

激光原位角膜磨镶术后，Scheimpflug 地形定向充分重新定位未对准的游离皮瓣

本报告描述了一例在激光原位角膜磨镶术 (LASIK) 后，Scheimpflug 地形定向充分重新定位未对准的厚游离皮瓣的案例。一名 24 岁患者因不规则散光和自由右眼皮瓣迷失方向而就诊。该患者之前在一家私人诊所接受了双眼 LASIK。在右眼手术期间，由于皮瓣游离，在激光烧蚀后皮瓣被重新定位。由于术前角膜标记不足，游离瓣没有重新定位到其原始配置。检查时，未矫正视力为 0.4，屈光度为 +2.00 Dsph，右眼 -4.25 Dcyl 轴 66。Scheimpflug 地形图显示右眼不规则散光。地形的矢状曲率显示角膜陡轴逆时针错位 40°。游离瓣通过顺时针旋转 40° 重新定位。此后，右眼屈光度数提高到 -1.00 Dsph，-1.00 Dcyl Axis 19。未矫正和最佳矫正视力分别提高到 20/30 和 20/25 (x − 0.25Dsph −1.25 Dcyl A20)。这是关于使用 Scheimpflug 地形进行自由皮瓣重新定位的第一份报告。由于没有术前角膜标记的游离 LASIK 皮瓣影响了皮瓣的正确定位，因此使用 Scheimpflug 地形图有效地重新定位皮瓣。这是关于使用 Scheimpflug 地形进行自由皮瓣重新定位的第一份报告。由于没有术前角膜标记的游离 LASIK 皮瓣影响了皮瓣的正确定位，因此使用 Scheimpflug 地形图有效地重新定位皮瓣。这是关于使用 Scheimpflug 地形进行自由皮瓣重新定位的第一份报告。由于没有术前角膜标记的游离 LASIK 皮瓣影响了皮瓣的正确定位，因此使用 Scheimpflug 地形图有效地重新定位皮瓣。
Case Rep Ophthalmol 2021；12:889–893