Maculopathies after Laser–assisted in situ Keratomileusis (LASIK)

Abstract

Abstract: : Purpose: To describe twenty–seven patients (eyes) who developed unilateral full–thickness macular hole or subfoveal choroidal neovascular membranes (CNV) after undergoing bilateral LASIK for the correction of ammetropia. Methods: Case series. Results: The macular hole formed between 1 to 30 moths after LASIK (mean: 9.1 months). Ninety percent of patients were female. Mean age was 42.5 years old (25–58). Ninety percent of eyes were myopic (range: –0.50 to –15.25 diopters [D]; mean: –7.94 D). Posterior vitreous detachment was not present before and was documented after LASIK on 80% of eyes. A vitrectomy closed the macular hole on 9/10 eyes that underwent surgical management with an improvement on final best–corrected visual acuity on 90% of patients. Our fifteen patients (eyes) with full–thickness macular hole after LASIK reflect an incidence of 0.03% (15/46,486). In addition, choroidal neovascularization occurred at a mean of 18.2 months (range: 12 to 14 months) after LASIK. Myopia in our patients had a mean of –15.12 D (range: –13:00 D to –25.50 D). Nine of our cases benefited from photodynamic therapy (PDT) with an improvement or stability of visual acuity in 77.7% of cases. Our 12 patients with CNV after LASIK reflect an incidence of 0.09% (12/13,298). Conclusion: LASIK seems to be a safe procedure with a low incidence of vitreo–retinal complications, however CNV and macular hole may develop after LASIK.

Keywords: refractive surgery: complications • macular holes • choroid: neovascularization