Central focal interface opacity after laser in situ keratomileusis.
BACKGROUND
The acute onset of a focal central interface opacity with visual loss following LASIK has not been described in the peer reviewed literature. Non-peer reviewed reports of various inflammatory lesions have been recorded.


METHODS
We describe three cases in which an acute focal stromal interface opacification was identified within 1 week of laser in situ keratomileusis (LASIK). Each case was performed by a different surgeon on a different day, but using the same method, materials, and the Summit Apex Plus excimer laser. Immediately after surgery, all eyes were normal with good unaided vision. The appearance of the central stromal opacity was associated with acute visual deterioration. Preoperative and postoperative cycloplegic refractions, videokeratography, and postoperative slit-lamp biomicroscopy were performed. Each case was treated with intensive topical corticosteroids.


RESULTS
Each case demonstrated a central circular opacity in the interface between corneal flap and stromal bed, with associated variable stromal thinning. Resolution of the pathological process followed 2 to 4 weeks of treatment with topical corticosteroids and subsequent improvement in slit-lamp biomicroscopy, corneal topography, and vision. Etiology was uncertain.


CONCLUSIONS
Central interface opacification is a rare but visually important inflammatory complication of LASIK.
Fraenkel
G E
GE
Sydney Refractive Surgery Centre, Chatswood, New South Wales, Australia.
Cohen
P R
PR
Sutton
G L
GL
Lawless
M A
MA
Rogers
C M
CM
D000208:Acute Disease; D000287:Administration, Topical; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003318:Corneal Opacity / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D003319:Corneal Stroma / Q000473:pathology / Q000601:surgery*; D019781:Corneal Topography; D005938:Glucocorticoids; D006801:Humans; D053685:Laser Therapy; D008297:Male; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D013524:Surgical Flaps; D014786:Vision Disorders / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D014792:Visual Acuity
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids