Wound instability and management after cataract surgery in a patient with prior laser in situ keratomileusis.
We report a case of cataract wound instability and subsequent management after cataract surgery in a patient who had had hyperopic laser in situ keratomileusis (LASIK). Standard cataract surgery was performed through a nasal limbal incision. One day postoperatively, the uncorrected visual acuity (UCVA) was 20/20 and the wound was stable. Subsequent examinations revealed overlying corneal edema, cataract wound slippage with corresponding with-the-rule astigmatism, and decreased vision. Separating and resuturing the cataract wound resulted in significant and stable improvement in the UCVA to 20/40. At 18 months, the best corrected visual acuity was 20/20 with a refraction of -3.50 +0.25x155 and keratometry of 44.75/45.00@155. Understanding wound stability and its management in cataract surgery in patients with prior LASIK refractive surgery will become increasingly important as more of these patients present.
Cheng
Clement J
CJ
Johns Hopkins University-Wilmer Eye Institute, Baltimore, Maryland 21287, USA.
Stark
Walter J
WJ
D000368:Aged; D001251:Astigmatism / Q000209:etiology; D002387:Cataract Extraction; D003315:Cornea / Q000601:surgery*; D015715:Corneal Edema / Q000209:etiology; D006801:Humans; D006956:Hyperopia / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ; D008297:Male; D011183:Postoperative Complications; D013536:Suture Techniques; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity; D014945:Wound Healing