Retinal detachment in myopic eyes after laser in situ keratomileusis.
OBJECTIVE
To analyze the incidence and characteristics of retinal detachment in myopic patients treated by laser-assisted in situ keratomileusis.


METHODS
We retrospectively studied the retinal detachments observed in 1,554 consecutive eyes (878 patients) undergoing laser-assisted in situ keratomileusis for the correction of myopia (follow-up, 30.34+/-10.27 months; range, 16 to 54). Mean patient age was 33.09+/-8.6 years (range, 20 to 60). Before treatment with laser-assisted in situ keratomileusis, all patients had a comprehensive examination, and detected lesions predisposing to retinal detachment were treated before performing the laser-assisted in situ keratomileusis procedure.


RESULTS
Retinal detachment occurred in four (0.25%) of 1,554 eyes of four (0.45%) of 878 patients. All four patients who developed retinal detachment in one eye were women. Degree of preoperative myopia was -13.52+/-3.38 diopters (range, -8.00 to -27.50). The time interval between refractive surgery and retinal detachment was 11.25+/-8.53 months (range, 2 to 19 months). In all cases retinal detachment was spontaneous. In all eyes the retina was reattached successfully at the first retinal detachment surgery. Mean best-corrected visual acuity after laser-assisted in situ keratomileusis and before retinal detachment development was 20/43 (range, 20/50 to 20/30). After retinal detachment repair, best-corrected visual acuity was 20/45 (range, 20/50 to 20/32). Differences between best-corrected visual acuity before and after reattachment were not statistically significant (P = .21, paired Student t test). A myopic shift was induced in three eyes that had retinal detachment repaired by scleral buckling, from -0.58+/-0.72 diopter (range, +0.25 to -1.00) before retinal detachment and -2.25+/-1.14 diopters (range, -1.00 to -3.25) after retinal detachment surgery (P = .03, paired Student t test).


CONCLUSIONS
Laser-assisted in situ keratomileusis for correction of myopia is followed by a low incidence of retinal detachment. Conventional scleral buckling surgery was successful in most cases and did not cause significant changes in the final best-corrected visual acuity. A significant increase in the myopic spherical equivalent was observed after scleral buckling in these patients.
Ruiz-Moreno
J M
JM
Department of Ophthalmology, Miguel Hernández University School of Medicine, Alicante, Spain. upr@xpress.es
Pérez-Santonja
J J
JJ
Alió
J L
JL
D000328:Adult; D016039:Corneal Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications; D011184:Postoperative Period; D012086:Reoperation; D012163:Retinal Detachment / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D012591:Scleral Buckling; D013997:Time Factors; D014792:Visual Acuity