Laser in situ keratomileusis-induced optic neuropathy.
OBJECTIVE
To report a case of bilateral optic neuropathy after bilateral laser-assisted in situ keratomileusis (LASIK) surgery.


METHODS
Observational case report.


METHODS
Complete eye examination with detailed evaluation of the optic nerve, detailed medical history, stereo disc photographs, GDx Nerve Fiber Analyzer testing, Humphrey 24-2 SITA visual field testing, diurnal intraocular pressure measurement, serologic evaluation, and magnetic resonance imaging of the brain and orbits.


METHODS
Optic nerve status, visual field status, and visual acuity.


RESULTS
A subject with previously healthy optic nerves had bilateral optic neuropathy develop after LASIK surgery. This neuropathy manifested with a subjective decrease in visual field, normal visual acuity, normal color vision, relative afferent pupillary defect, increased cupping of the optic nerve with focal neuroretinal rim defects, decreased nerve fiber layer thickness, and nerve fiber bundle-type visual field defects. The subject had no other risk factors for optic neuropathy. No other cause of neuropathy was identified.


CONCLUSIONS
Optic neuropathy is a potential vision-threatening complication of LASIK surgery. This complication may be due to barotrauma or ischemia related to extreme elevation of intraocular pressure by the suction ring. Careful examination of the optic nerve before and after LASIK surgery is warranted.
Cameron
B D
BD
Division of Ophthalmology, Maimonides Medical Center, Brooklyn, NY 11219, USA.
Saffra
N A
NA
Strominger
M B
MB
D000328:Adult; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D009216:Myopia / Q000601:surgery; D009412:Nerve Fibers / Q000473:pathology; D009900:Optic Nerve / Q000473:pathology; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000209:etiology*; D011681:Pupil Disorders / Q000175:diagnosis / Q000209:etiology; D012165:Retinal Ganglion Cells / Q000473:pathology; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields