Hyperopic LASIK was equally effective and predictable in treating consecutive hyperopia after overcorrected M-LASIK and overcorrected RK. The safety of the procedure in the RK group appeared to be inferior to that in the M-LASIK group. Although vision-threatening complications are rare after H-LASIK retreatment, corneal ectasia developed in 1 eye in the RK group.
Several conclusions can be drawn from this study. First, LASIK retreatment is effective and safe for correcting undercorrection and regression after initial LASIK, and a good visual outcome is expected. Second, in most eyes, regression occurs within 6 months after the initial LASIK. However, regression can develop up to 2 years after LASIK. Third, multiple retreatments will be required in some patients. The outcome in these cases is promising.
We report a case in which diffuse interface keratitis began 1 week after bilateral uneventful laser in situ keratomileusis (LASIK). A layer of fluid in the interface with epithelial ingrowth was noted in the left eye 20 days postoperatively. The same complication occurred in the right eye 5 months after LASIK. Dry-eye syndrome and steroid-induced intraocular pressure elevation occurred in this patient with pre-existing ocular hypertension. A long course of interface inflammation was resistant to topical steroids. Surgical removal of the epithelial ingrowth and drainage of the fluid, combined with medical treatment, resulted in resolution of the inflammation. The cytopathologic examination of the fluid showed epithelial cells without signs of inflammation. The clinical features of this case represent a new complication of LASIK.
The results of this study of highly myopic eyes indicate that treating retinal pathology preoperatively and using the sutureless procedure, phacoemulsification, and in-the-bag IOL placement lead to good visual outcome, a lower rate of retinal complications, and a more stable wound.
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