Fibrin glue to manage flap necrosis secondary to late-onset infectious keratitis after laser in situ karatomileusis

A 52-year-old man developed flap necrosis secondary to late-onset infectious keratitis after laser in situ keratomileusis. Management involved a flap lift and irrigation of the interface with fortified antibiotics. The flap was then replaced, and fibrin glue was placed at the flap edges and over the necrotic area to seal it completely. Two months after surgery, the corrected distance visual acuity was 20/20 and a slitlamp examination showed no signs of infection. Localized flap necrosis can be adequately managed with fibrin glue, including in cases of herpes simplex virus keratitis.