Iatrogenic keratectasia after LASIK for .4.0 to .7.0 dioptres of myopia
S.Percy Amoils, Mark Deist, Petrus Gous, Philippa M.Amoils

ABSTRACT

Purpose:
To study 13 eyes with .4.0 to .7.0 D of myopia that developed central or inferior keratectasia after LASIK.

Methods:
The progress of ectasia was determined by a series of pre- and post-LASIK topographies and the case histories.

Results:
Progressive ectasia developed from 1 week to 27 months after LASIK. This necessitated the wearing of hard contact lenses or penetrating keratoplasty. One eye improved for some months after PRK retreatment. Two eyes in one patient and one eye in a second patient had latent keratoconus before surgery.

Conclusion:
LASIK can cause permanent weakening and ectasia of the cornea even in eyes with low myopia.
 

Parolini B. Marcon G. Panozzo GA. Teclo Refractive Surgery Center, Verona, Italy.
Central necrotic lamellar inflammation after laser in situ keratomilcusis
Journal of Refractive Surgery. 17(2):110-2, 2001 Mar-Apr.

ABSTRACT

Purpose:
To report four cases of corneal interface complications that occurred after excimer laser in situ keratomileusis (LASIK).

Methods:
Four eyes of three patients underwent technically uneventful LASIK.

Results:
One day after LASIK, patients presented with severe pain, blurred vision, conjunctival infection, and diffuse opacity at the interface. Two days after LASIK, significant features were central opacity, striae in the flap, loss of uncorrected and best spectacle-corrected visual acuity, and corneal sensitivity. The findings did not improve by using drugs or by lifting the flap and irrigating the bed. The central opacity partially resolved over 8 to 12 months, leaving a hyperopic shift (one patient), striae (one patient), and loss of two or more lines of best spectacle-corrected visual acuity (three patients).

Conclusion:
This severe central inflammation after LASIK could be an extreme
manifestation of diffuse lamellar keratitis.
 

Lemley HL. Chodosh J. Wolf TC. Bogie CP. Hawkins TC.
Department of OphthahnoloRy, Dean A. MeGee Eye Institute, University of Oklahoma
Health Sciences Center, Oklahoma City, USA.

Partial dislocation of laser in situ keratomileusis flap by air bag injury
Journal of Refractive Surgery. 16(3):373-4, 2000 May-Jun.

ABSTRACT

Purpose:
A patient developed significant corneal complications from air bag deployment, 17 months after laser in situ keratomileusis (LASIK).

Methods:
Case report, slit-lamp microscopy, and review of the medical literature.

Results:
A 37-year-old woman underwent bilateral LASIK with resultant 20/20 uncorrected visual acuity. Seventeen months later, she sustained facial and ocular injuries from air bag deployment during a motor vehicle accident. Examination revealed bilateral corneal abrasions, partial dislocation of the right corneal LASIK flap), and a hyphema in the right eve. The LASIK flap was realigned, but recovery was complicated by a slowly healing epithelial defect and flap edema. One month following the injury, epithelial ingrowth beneath the LASIK flap was noted. Surgical elevation of the flap and removal of the epithelial ingrowth was performed. Eight months later, epithelial ingrowth was absent and the visual acuity was 20/40. Residual irregular astigmatism necessitated rigid gas permeable contact lens fitting to achieve 20/20 visual acuity.

Conclusions:
Air bags may cause significant ocular trauma. The wound healing response of LASIK allows corneal flap separation from its stromal bed for an indeterminate time after surgery. Discussion of the possible risk of corneal trauma as part of informed consent prior to LASIK may be appropriate.