Macular hemorrhage after LASIK for high myopia: a causal association?

Retinal Phlebitis After LASIK

PURPOSE

To report a case of retinal phlebitis with cystoid macular edema in both eyes 8 weeks after LASIK.

METHODS

A 30-year-old woman underwent bilateral myopic LASIK. Eight weeks postoperatively, the patient experienced blurred vision in the left and right eyes. Fundus examination showed focal whitish patches in the parafoveal and juxtafoveal areas and lack of foveal reflex in both eyes. A diagnosis of retinal phlebitis with cystoid macular edema was made, which was treated with oral corticosteroids with tapering dose.

RESULTS

Visual acuity returned to normal and the whitish fundus patches decreased in number and size in both eyes.

CONCLUSIONS

Surgeons should be aware of potential risks and retinal complications associated with LASIK.

Complete bilateral vitreous detachment after LASIK retreatment

We describe a case of a 47-year-old woman who underwent bilateral laser in situ keratomileusis (LASIK) for the correction of myopia and astigmatism. Two months later a residual refractive error was present in both eyes. LASIK retreatment was decided and performed the following day. Twenty-four hours after the procedure, the patient reported myodesopsia in both eyes. Funduscopic examination revealed a complete bilateral posterior vitreous detachment confirmed by kinetic ultrasound. Visual disturbance in both eyes continued to be present after 10 months of follow-up. Sudden changes in intraocular pressure related to suction ring use might be the cause of posterior vitreous detachment in this patient.

Retinal pathology occurring after excimer laser surgery or phakic intraocular lens implantation: evaluation of possible relationship

The increasing number of patients undergoing refractive surgery has led to an awareness of the potential retinal complications of these procedures. The purpose of this review is to summarize the reports of retinal pathology and myopic maculopathy that have occurred after excimer refractive surgery or implantation of phakic intraocular lenses, and to evaluate theoretical pathogenetic mechanisms. We found it reasonable to conclude that retinal detachments and macular hemorrhages are not caused by laser surgery, but are rather characteristic of the natural history in the myopic eye. However, although there is no clear-cut evidence for a cause-and-effect relationship between excimer laser surgery and retinal pathology, it is very important to inform patients that refractive surgery only corrects the refractive aspect of myopia, and that the myopia itself still has the potential for serious complications.