Macular hemorrhage after laser in situ keratomileusis (LASIK) with femtosecond laser flap creation

• Published in: American journal of ophthalmology 2004-10, Vol.138 (4), p.657-659
• Main Authors: Principe, Alexandre H., Lin, Danny Y., Small, Kent W., Aldave, Anthony J.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Corneal Stroma - surgery; Cracks; Female; Fluorescein Angiography; Glaucoma; Humans; Keratomileusis, Laser In Situ - adverse effects; Lasers; Macular degeneration; Medical sciences; Myopia - surgery; Retinal Hemorrhage - diagnosis; Retinal Hemorrhage - etiology; Retinal Hemorrhage - physiopathology; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Surgical Flaps; Visual Acuity
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2004.04.030

To report the first case of macular hemorrhage following laser in situ keratomileusis (LASIK) with femtosecond laser flap creation. Observational case report. A 36-year-old woman underwent uncomplicated, bilateral, simultaneous LASIK procedures for correction of moderate myopia (−5.00 diopters OD and −6.00 diopters OS). LASIK flap creation was performed using the IntraLase femtosecond laser. On postoperative day 1, the patient's uncorrected and best-corrected visual acuities were 20/20 OD and 20/40 OS. A dilated fundoscopic examination revealed a one-third disk diameter macular hemorrhage OS. An intravenous fluorescein angoiogram ruled out the presence of predisposing macular pathology. Two months after LASIK, the macular hemorrhage had cleared, and 6 months later, the BCVA improved to 20/25 OS. Macular hemorrhage may occur after LASIK, even in the absence of previously identified risk factors, such as high myopia, pre-existing choroidal neovasculaization, lacquer cracks, and sudden changes in intraocular pressure associated with microkeratome-assisted flap creation.