Elevated intraocular pressure‐induced interlamellar keratitis in a patient with LASIK surgery 14 years ago

• Published in: Acta ophthalmologica (Oxford, England) England), 2022-01, Vol.100 (S267), p.n/a
• Main Authors: Arias, Pablo Cisneros, El Bakkali, Ismael Bakkali, Puyuelo, Javier Ascaso, Muro, Enrique Minguez, Moscarda, Eva Nuñez, Rivas, Marta Orejudo, Pérez‐Rivasés, Guillermo, Murillo, Ana Boned, Barreda, Maria Dolores Díaz
• Format: Article
• Language: English
• Subjects: Acetazolamide; Acuity; Cornea; Corticosteroids; Diabetes mellitus; Diabetic retinopathy; Edema; Emergency medical care; Eye surgery; Glaucoma; Keratitis; Lasers; Patients; Pharmacists; Pressure; Retinopathy; Steroids; Surgery; Timolol; Uveitis
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2022.042

Purpose To describe a case of interlamellar keratitis induced by elevated intraocular pressure (IOP) in a patient with a history of LASIK surgery and the importance of having a strong diagnostic suspicion for establishing adequate treatment. Methods Intraocular pressure‐induced interlamellar keratitis is one of the potential complications of LASIK refractive surgery. The cases described generally occur a few months after surgery although there are some cases that have been described several years after surgery, usually in a context of uveitis and corticosteroid treatment or silent glaucoma. We present a case of 43‐year‐old woman who came to the emergency room with visual acuity (VA) impairment in the left eye in the setting of elevated intraocular pressure‐induced interlamellar keratitis secondary to the intravitreal corticosteroid implant in her left eye due to a diabetic retinopathy. She underwent LASIK surgery 14 years ago. Results The treatment was based on lowering the intraocular pressure. Oral acetazolamide and topical timolol, bimatoprost and brinzolamide were used. The patient recovered her baseline VA and the IOP were properly controlled posteriorly. Conclusions This case shows the importance of considering this diagnosis in patients with corneal haze, elevated intraocular pressure and a history of LASIK surgery to establish an adequate treatment. A full recovery is expected. Bibliography 1. Galal A, Artola A, Belda J, (2006) Interface corneal edema secondary to steroid‐induced elevation of intraocular pressure simulating diffuse lamellar keratitis. Journal of refractive surgery. 2. Lee V, Sulewski M, Zaidi A (2010) Elevated Intraocular Pressure–Induced Interlamellar Stromal Keratitis Occurring 9 Years After Laser In Situ Keratomileusis. Corneal Journal. 3. Lyle W, Jin G, Jin Y (2003) Interface fluid after laser in situ keratomileusis. Journal of refractive surgery. 4. Tourtas T, Kopsachilis N, Meiller R, et al. (2010). Pressure‐Induced Interlamellar Stromal Keratitis After Laser In Situ Keratomileusis. Corneal Journal.