Complication cascade after hyperopic LASIK

This report concerns the case of a 28-year-old female patient who was treated with topical steroids for 2 years following complicated hyperopic LASIK surgery with a re-treatment including a re-lift of the flap. A steroid-induced rise in the intraocular pressure (IOP) was subsequently observed on the...

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Bibliographic Details
Published in:Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft 2011-07, Vol.108 (7), p.665
Main Authors: Handzel, D M, Stanzel, B V, Briesen, S
Format: Article
Language:ger
Subjects:
Adult
Anti-Inflammatory Agents - administration & dosage
Anti-Inflammatory Agents - adverse effects
Corneal Topography
Dexamethasone - administration & dosage
Dexamethasone - adverse effects
Diagnostic Errors
Female
Glaucoma - chemically induced
Glaucoma - diagnosis
Gonioscopy
Humans
Hyperopia - surgery
Intraocular Pressure - drug effects
Keratomileusis, Laser In Situ - adverse effects
Long-Term Care
Ophthalmic Solutions
Ophthalmoscopes
Optic Nerve - drug effects
Postoperative Care
Postoperative Complications - diagnosis
Postoperative Complications - drug therapy
Postoperative Complications - surgery
Reoperation
Tomography, Optical Coherence
Visual Acuity - drug effects
Visual Fields - drug effects
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Summary:This report concerns the case of a 28-year-old female patient who was treated with topical steroids for 2 years following complicated hyperopic LASIK surgery with a re-treatment including a re-lift of the flap. A steroid-induced rise in the intraocular pressure (IOP) was subsequently observed on the treated eye, together with a glaucomatous subtotal destruction of the optic nerve, resulting in a residual vision of 1/15. An erroneously low IOP measurement, which was probably the reason for the delay in detecting steroid-induced glaucoma, has been reported in several cases concerning LASIK patients. The reason for the unusually severe course in the case in question can only be presumed, namely a possible accumulation of fluid at the interface or altered biomechanics following hyperopic LASIK surgery. The need for a thorough postoperative examination following refractive surgery must be emphasized. This case shows a cascade of complications following hyperopic LASIK surgery resulting in the functional blindness of one eye.
ISSN:1433-0423
DOI:10.1007/s00347-011-2347-4