Severe corneal epithelial sloughing during laser in situ keratomileusis as a presenting sign for silent epithelial basement membrane dystrophy

Abstract

Occurrence of large intraoperative epithelium sloughing/defects during LASIK might be a diagnostic sign for subclinical EBMD. These patients are predisposed to multiple postoperative complications. Because of the high risk for epithelial sloughing in the second eye, LASIK should not be performed.

Early phototherapeutic keratectomy for basement membrane dystrophy after laser in situ keratomileusis

“…As a result of the difficulty managing this complication, Pérez-Santonja et al 6 propose that when large epithelial sloughing is observed during LASIK in the first eye, the surgeon should expect similar behavior in the fellow eye; LASIK should not be performed, and surface ablation procedures should be considered. However, epithelial sloughing during LASIK is not always associated with postoperative symptoms of EBMD; furthermore, it may be difficult to explain the choice of a surface ablation procedure in the second eye, with the accompanying more painful and slower visual rehabilitation, when the LASIK-treated eye had an uneventful postoperative rehabilitation.…”

Referrals to the Wills Eye Institute Cornea Service after laser in situ keratomileusis: Reasons for patient dissatisfaction

“…Surgeon error includes incorrect patient or parameter settings in the laser or operating on the incorrect eye [4][5][6][12][13][14]. Over the study period, patients presented with a wide variety of complications and complaints.…”

Photorefractive keratectomy in eyes with atypical topography

“…[54][55][56] Although it is often difficult to detect anterior basement membrane dystrophy clinically, it also can cause atypical topography. 57 Contact lens warpage may take many months to resolve and may have an appearance on topography similar to that of keratoconus. 58,59 …”