Retinal Detachment in Myopic Eyes After Laser in situ Keratomileusis.

Continuous intraocular pressure recordings during lamellar microkeratotomy of enucleated human eyes

“…Abrupt changes in IOP may cause vitreous traction, leading to retinal breaks and rhegmatogenous retinal detachments, 3 premacular subhyaloid hemorrhages, 4 and macular holes. 5 Laser in situ keratomileusis-induced IOP elevation has also been implicated in serous macular detachments, 6 choroidal neovascular membranes associated with lacquer cracks, 7 acute optic neuropathies, 8,9 cilioretinal artery occlusions, 10 and various unexplained visual field defects. 11,12 Moreover, anterior ischemic optic neuropathy has been reported after ocular plethysmography, which increases IOP to 110 to 140 mm Hg for only 3 to 5 seconds with return to normal by 30 seconds.…”

“…Elevation or rapid fluctuations in IOP during LASIK have been implicated as the cause of postoperative optic nerve and vitreoretinal complications. [3][4][5][6][7][8][9][10][11][12] The actual course of IOP during LMK in human eyes has not been fully elucidated, and a comparison of various microkeratomes in relation to induced IOP levels has, to our knowledge, not been previously performed. Despite reports of presumed IOP-related complications associated with LASIK, the actual clinical research has been limited.…”

Experimental observation of intraocular pressure changes during microkeratome suctioning in laser in situ keratomileusis

“…Even though this level is maintained momentarily, higher IOP spikes during suctioning are special concerns in patients with glaucoma, optic nerve disease, and pathologies of the vitreous and retina. 3,4 Mechanical stretching of the vitreous base caused by the suction ring has been described, 5 and the traction on the vitreous base caused by the suction ring may cause retinal breaks. 6 Thus, the sites that would be most affected by IOP changes should be considered.…”

Retinal Complications After Refractive Surgery

“…Ruiz-Moreno and colleagues reported only a single case of MH in their series of 3009 eyes treated with myopic LASIK. 5,16 There are even fewer case reports of MHs after PRK, including 1 case of bilateral MH formation within 4 months after myopic PRK. 15,23 Vitreoretinal interface changes during keratorefractive surgery may play a role.…”

“…1,4,5 Other retinal pathologies noted after LASIK include choroidal neovascularization (CNV), 5-7 macular hemorrhage, [8][9][10] lacquer crack, 8,11,12 and macular hole (MH). [13][14][15][16] Nearly all of these other complications are, in fact, manifestations of myopic maculopathy. Retinal detachment, 5,[17][18][19] CNV, 5,20,21 macular hemorrhage, 22 MH, 15,23 and cystoid macular edema (CME) 24 have been reported after PRK.…”