Complications associated with anterior basement membrane dystrophy after laser in situ keratomileusis.
OBJECTIVE
To evaluate the complications associated with anterior basement membrane dystrophy (ABMD) after laser in situ keratomileusis (LASIK).


METHODS
Cornea Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.


METHODS
In this noncontrolled retrospective case series, the medical records of all patients with LASIK complications seen in the Cornea Service at Wills Eye Hospital from January 1, 1998, to December 31, 2002, were reviewed. All patients who presented with ABMD changes after LASIK were included in the study. Patients with a history of trauma before or after surgery were excluded.


RESULTS
Thirty-five eyes of 18 patients were included. The mean age was 46.2 years. Thirteen eyes (37.1%) had a flap-lift procedure to remove epithelial ingrowth or for an enhancement. The most common reason for the visit was visual complaints, which were seen in 77.8% of patients. Seven patients (38.9%) had visual complaints alone; 27.8% had visual complaints associated with recurrent erosions and 11.1%, with dry eyes. Four patients (22.2%) had recurrent corneal erosions with no visual complaints. On examination, the most common finding was negative staining with fluorescein dye within the LASIK flap, which was seen in all patients. In addition to the ABMD changes, 25.7% had some degree of epithelial ingrowth and 45.7%, irregular astigmatism.


CONCLUSIONS
Anterior basement membrane dystrophy changes post LASIK were associated with visual complaints and/or recurrent erosions. Patients should be carefully screened for ABMD. Those who have ABMD signs or symptoms may not be ideal candidates for LASIK.
Rezende
Renata A
RA
Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania 19107, USA.
Uchoa
Uchoandro C
UC
Cohen
Elisabeth J
EJ
Laibson
Peter R
PR
Rapuano
Christopher J
CJ
D000328:Adult; D000368:Aged; D001485:Basement Membrane / Q000473:pathology*; D003287:Contrast Media; D003317:Corneal Dystrophies, Hereditary / Q000209:etiology*; D019781:Corneal Topography; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D019793:Fluorescein; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D054140:Refractive Surgical Procedures; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps; D014786:Vision Disorders / Q000209:etiology*
D003287:Contrast Media; D019793:Fluorescein