Rhegmatogenous Retinal Detachment in Myopic Eyes After Laser In Situ Keratomileusis and Laser Subepithelial Keratomileusis

Abstract

Abstract: : Purpose: To report the clinical characteristics, surgical management and outcome of rhegmatogenous retinal detachment (RRD) after laser in situ keratomileusis (LASIK) and laser subepithelial keratomileusis (LASEK) Methods: Retrospective review of 3 eyes of 3 myopic patients with RRD who had previously undergone LASIK or LASEK surgery was analyzed. Mean patients age was 33.33±7.51 years (range 23 to 41). Two of the three patients had peripheral retinal tear or atrophic hole lesions predisposing to retinal detachment and were treated with argon laser photocoagulation or cryotherapy before performing LASIK or LASEK. Results: Degree of preoperative myopia was -10.17±4.23 diopters (range, -5.50 to -13.75). The interval between refractive surgery and RD was 10.33±10.21 months (range, 3 to 22). In all cases retina was reattached successfully at the first retinal detachment surgery. Two out of three cases of retinal detachment were spontaneous and one had ocular trauma. Mean best-corrected visual acuity after refractive surgery before retinal detachment was 0.83±0.21 (range, 0.6 to 1.0). After RD repair, best-corrected visual acuity was 0.63±0.29. A myopic shift was induced in all eyes that had retinal detachment repaired by scleral buckling, from -0.50±0.90 diopters (range, 0.25 to -1.50) before RD and -1.62±1.52 diopters (range, -0.25 to -3.25) after retinal detachment surgery. An increase in cylinder was also found in all eyes that had retinal detachment surgery, from 0.92±0.29 diopters (range, 0.75 to 1.25) before RD and 1.58±0.72 diopters (range, 0.75 to 2.00) after retinal detachment surgery. Conclusions: Conventional prophylactic argon laser photocoagulation or cryotherapy on the peripheral retinal pathology was not sufficient to prevent RRD following refractive surgery. Therefore, patients should have a thorough dilated indirect fundoscopy with scleral depression and more complete treatment of any retinal lesion predisposing to the development of RRD should be treated before LASIK as well as LASEK. A significant increase in the myopia and cylinder were observed after scleral buckling in these patients.

Keywords: cornea: clinical science • refractive surgery: complications • retinal detachment