Photodynamic Therapy (PDT) with Verteporfin for Subfoveal Choroidal Neovascular Membranes in Highly Myopic Eyes after Laser–assisted in situ Keratomileusis (LASIK)

Abstract

Abstract: : Purpose: The authors report the management of subfoveal choroidal neovascular membranes (CNV) in highly myopic eyes after laser–assisted in situ keratomileusis (LASIK) with photodynamic therapy (PDT) with verteporfin. Methods: Case series. Results: Choroidal neovascularization occurred at a mean of 18.2 months (range: 12 to 14 months) after LASIK. Nine cases of CNV after LASIK for the correction of myopia (mean: –12.5 D; range: –6.50 D to –16.25 D) treated with single or multiple sessions of PDT with verteporfin are presented. Four cases improved visual acuity (VA) (2–5 lines) after PDT, three cases remained the same, and two cases lost VA (2–4 lines). Our two failures were associated to subretinal fibrosis after PDT. Conclusion: Photodynamic therapy with verteporfin seems to increase the chance of stabilizing or improving vision in patients with subfoveal CNV after LASIK in high myopes. Visual acuity improved or remained the same in 77.7% of cases. Avoiding induced astigmatism may be important in eyes that have undergone refractive surgery. Photodynamic therapy with verteporfin for the management of CNV after LASIK in highly myopic eyes does not change the shape of the globe and has a low incidence of complications. These are significant advantages over the available surgical options (macular translocation, and surgical removal).

Keywords: choroid: neovascularization • photodynamic therapy • myopia