Early transient visual acuity loss after LASIK due to steroid-induced elevation of intraocular pressure.
OBJECTIVE
To report the clinical course of early transient reduction of uncorrected visual acuity (UCVA) after LASIK surgery resulting from steroid-induced elevation of intraocular pressure (IOP).


METHODS
Twenty-nine eyes of 15 patients who received topical corticosteroids after uneventful myopic LASIK surgery and had a decrease in UCVA within the first 3 weeks were evaluated retrospectively.


RESULTS
Intraocular pressure increased by 4 to 30 mmHg from preoperative to postoperative days 4 to 20. Twenty-seven of 29 eyes had a decrease in UCVA and/or best spectacle-corrected visual acuity (BSCVA). All eyes, except one, had edema without evidence of inflammation in the interface or the remainder of the cornea. Discontinuation of topical corticosteroids and application of anti-glaucoma medications resulted in a decrease of IOP to normal levels, reduction or disappearance of the edema, and recovery of BSCVA.


CONCLUSIONS
Early onset steroid-induced elevation of IOP after LASIK may cause corneal edema and a sudden decrease in UCVA. Rapid diagnosis and treatment can control IOP and recover the visual loss.
Frucht-Pery
Joseph
J
Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Landau
David
D
Raiskup
Frederik
F
Orucov
Faik
F
Strassman
Eyal
E
Blumenthal
Eytan Z
EZ
Solomon
Abraham
A
D000328:Adult; D019781:Corneal Topography; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D020731:Keratomileusis, Laser In Situ; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000139:chemically induced*; D011239:Prednisolone / Q000009:adverse effects / Q000031:analogs & derivatives*; D014786:Vision Disorders / Q000209:etiology*; D014792:Visual Acuity
D005938:Glucocorticoids; C009935:prednisolone acetate; D011239:Prednisolone