Pressure-induced stromal keratopathy after laser in situ keratomileusis: Acute and late-onset presentations

Cabral‐Macías, Jesús; Rosa, Guillermo Garcia-De la; Rodríguez-Matilde, Diana F.; Vela-Barrera, Ivan Daryl; Ledesma-Gil, Jasbeth; Ramírez-Miranda, Arturo; Graue-Hernández, Enrique O; Navas, Alejandro

doi:10.1016/j.jcrs.2018.06.053

Cited by 13 publications

(4 citation statements)

References 17 publications

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“…This coincides with the observation of authors that steroid-induced glaucoma and pressure-induced keratopathy may appear as acute or lateonset events, and may disrupt the reliability of readings and subsequent equations. 23,24 A study by Corenemberger et al showed that both eyes of the same patient may have different refraction corneal thicknesses, and consequently different ablation depth; 25 therefore, we studied both eyes of the same patient to ensure that the eye chosen had no negative effect on the results.…”

Section: Discussionmentioning

confidence: 99%

<p>Intraocular Pressure Calculation in Myopic Patients After Laser-Assisted In Situ Keratomileusis</p>

Helmy¹,

Hashem²

2020

OPTH

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Background: Corneal refractive surgery is widely used worldwide. Myopia is the most common reason for laser-assisted corneal refractive surgery (LASIK) and one of the risk factors for glaucoma. Intraocular pressure (IOP) measurement becomes variable postoperatively as the results are affected by the decrease in corneal thickness and biomechanics. This prospective clinical case study attempted to establish a simple correction formula for the calculation of IOP in post-LASIK myopic patients. Methods: This study included 300 eyes of 150 patients with myopia and myopic astigmatism as a refractive error who underwent LASIK. IOP was measured preoperatively and 6 months postoperatively. Preoperative and postoperative corneal thickness as well as ablation depth were measured. Statistical analysis was performed to detect the relationship between ablation depth and change in IOP. An attempt was made to construct a correction formula for the calculation of post-LASIK IOP. Results: The age of the patients ranged between 18 and 50 (mean ± SD 34.78±8.8) years. The spherical equivalent of refractive error ranged between −1.5 and −10 diopters. The mean IOP decreased significantly from 15.72±2.37 mmHg preoperatively to 11.71±2.24 mmHg postoperatively, with a mean difference of 4±1.75 mmHg (p˂0.001). A positive correlation was detected between corneal thickness and IOP difference among patients both preoperatively and postoperatively (p˂0.001). A positive correlation was identified between ablation depth and IOP change (p˂0.001). The correction formula for IOP was established: Real IOP=4+0.7(preoperative IOP)−0.3(ablation depth). Conclusion: IOP measurements change after corneal refractive surgery with LASIK. A corrected formula may be a good option for the proper calculation of post-LASIK IOP.

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Section: Discussionmentioning

confidence: 99%

<p>Intraocular Pressure Calculation in Myopic Patients After Laser-Assisted In Situ Keratomileusis</p>

Helmy¹,

Hashem²

2020

OPTH

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“…1 It has been reported to occur secondary to elevated intraocular pressure (IOP) and endothelial insufficiency, typically within weeks to months after LASIK. 2 Late occurrences of IFS are rare, and to the best of our knowledge, we present the latest documented onset to date.…”

mentioning

confidence: 85%

Interface Fluid Syndrome 2 Decades After Laser-Assisted In situ Keratomileusis

Assayag

Smadja²,

Roditi³

et al. 2021

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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To report a case of late-onset interface fluid syndrome (IFS) after laser-assisted in situ keratomileusis (LASIK). Methods: A 94-year-old man was referred for evaluation because of persistent corneal edema 10 days after Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) for pseudophakic bullous keratopathy. Results: After an uneventful DSAEK, the patient was treated with topical antibiotics and steroids. On presentation, a well positioned and oriented DSAEK graft was observed in the right eye, yet the cornea was edematous. Applanation tonometry was normal. Anterior-segment optical coherence tomography (AS-OCT) revealed a LASIK flap with a fluid cleft beneath it. Requery confirmed that LASIK was performed 21 years ago. Topical steroids were stopped, and after 2 weeks, the cornea was clear, and AS-OCT revealed complete resolution of the interface fluid. Conclusions: Even decades later, IFS should be considered as a source of corneal edema in patients after LASIK. Monitoring these patients with AS-OCT is recommended.

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“…What shall we do? Management includes cessation of corticosteroid therapy and introduction of antiglaucoma therapy for avoiding glaucomatous optic nerve damage [69,70].…”

Section: Pressure-induced Stromal Keratitismentioning

confidence: 99%

When LASIK Goes Wrong or LASIK Complications Dilemmas

Gilevska¹,

Bohač²,

Suić³

et al. 2022

Refractive Surgery - Types of Procedures, Risks, and Benefits

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Laser in situ keratomileusis (LASIK) is one of the most commonly performed refractive surgical procedures. During the last two decades, surgical procedure has evolved, but still, there are several intraoperative and postoperative complications possible. Every young LASIK surgeon spends most of the reading time on LASIK complications. They are not frequent, but you have to know precisely what to do when they happen. This chapter should be a guide, based on literature and experience, on how to deal with intraoperative, early postoperative, and late postoperative complications. This chapter will include managing irregular flaps, buttonholes, and free flaps. The treatment scheme for DLK, epithelial ingrowth, and PISK, and when is the time for flap re-lifting. How frequent should be patients’ visits not to miss the complication on time? When is the right time for LASIK reoperation? Post LASIK corneal ectasia and how to perform cross-linking over LASIK. Young surgeons need precise guidelines, not just theoretical treatment options to achieve optimal visual outcomes after LASIK procedure.

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Pressure-induced stromal keratopathy after laser in situ keratomileusis: Acute and late-onset presentations

Cited by 13 publications

References 17 publications

<p>Intraocular Pressure Calculation in Myopic Patients After Laser-Assisted In Situ Keratomileusis</p>

<p>Intraocular Pressure Calculation in Myopic Patients After Laser-Assisted In Situ Keratomileusis</p>

Interface Fluid Syndrome 2 Decades After Laser-Assisted In situ Keratomileusis

When LASIK Goes Wrong or LASIK Complications Dilemmas

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