title: Acute corneal edema with subsequent thinning and hyperopic shift following selective laser trabeculoplasty.
abstract: We report 4 cases of acute corneal edema with subsequent thinning and hyperopic shift following routine selective laser trabeculoplasty (SLT) for the treatment of primary open-angle glaucoma. Four women from 3 clinical sites developed acute corneal edema and haze within 2 days of uneventful SLT. In the following weeks to months, all treated corneas thinned to below pre-procedure thicknesses with resultant hyperopic shifts of nearly 2.0 diopters (D) to greater than 6.0 D. All eyes were moderately to highly myopic prior to SLT (spherical equivalent from -5.00 to -12.5 D). The corrected distance visual acuity 6 to 11 months after SLT was within 2 Snellen lines of the pre-procedure acuity in all patients; 2 patients required contact lenses. Corneal edema with subsequent corneal thinning and resultant hyperopic shift is an uncommon but possibly underrecognized complication of SLT, the etiology of which remains unknown but may be associated with moderate to high myopia.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the UPMC Eye Center (Knickelbein, Davis, Raju, Schuman, Conner), Department of Ophthalmology, University of Pittsburgh School of Medicine, the Department of Bioengineering (Schuman), Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania; the Cole Eye Institute (Singh, Eisenberg), Cleveland Clinic Foundation, Cleveland, Ohio; Ophthalmology Associates (Flowers, Nair), Fort Worth, Texas, USA.
authors.forename: Jared E
authors.initials: JE
authors.lastname: Knickelbein
authors.affiliation: From the UPMC Eye Center (Knickelbein, Davis, Raju, Schuman, Conner), Department of Ophthalmology, University of Pittsburgh School of Medicine, the Department of Bioengineering (Schuman), Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania; the Cole Eye Institute (Singh, Eisenberg), Cleveland Clinic Foundation, Cleveland, Ohio; Ophthalmology Associates (Flowers, Nair), Fort Worth, Texas, USA.
authors.forename: Annapurna
authors.initials: A
authors.lastname: Singh
authors.affiliation: From the UPMC Eye Center (Knickelbein, Davis, Raju, Schuman, Conner), Department of Ophthalmology, University of Pittsburgh School of Medicine, the Department of Bioengineering (Schuman), Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania; the Cole Eye Institute (Singh, Eisenberg), Cleveland Clinic Foundation, Cleveland, Ohio; Ophthalmology Associates (Flowers, Nair), Fort Worth, Texas, USA.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Flowers
authors.affiliation: From the UPMC Eye Center (Knickelbein, Davis, Raju, Schuman, Conner), Department of Ophthalmology, University of Pittsburgh School of Medicine, the Department of Bioengineering (Schuman), Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania; the Cole Eye Institute (Singh, Eisenberg), Cleveland Clinic Foundation, Cleveland, Ohio; Ophthalmology Associates (Flowers, Nair), Fort Worth, Texas, USA.
authors.forename: Unni K
authors.initials: UK
authors.lastname: Nair
authors.affiliation: From the UPMC Eye Center (Knickelbein, Davis, Raju, Schuman, Conner), Department of Ophthalmology, University of Pittsburgh School of Medicine, the Department of Bioengineering (Schuman), Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania; the Cole Eye Institute (Singh, Eisenberg), Cleveland Clinic Foundation, Cleveland, Ohio; Ophthalmology Associates (Flowers, Nair), Fort Worth, Texas, USA.
authors.forename: Marina
authors.initials: M
authors.lastname: Eisenberg
authors.affiliation: From the UPMC Eye Center (Knickelbein, Davis, Raju, Schuman, Conner), Department of Ophthalmology, University of Pittsburgh School of Medicine, the Department of Bioengineering (Schuman), Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania; the Cole Eye Institute (Singh, Eisenberg), Cleveland Clinic Foundation, Cleveland, Ohio; Ophthalmology Associates (Flowers, Nair), Fort Worth, Texas, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Davis
authors.affiliation: From the UPMC Eye Center (Knickelbein, Davis, Raju, Schuman, Conner), Department of Ophthalmology, University of Pittsburgh School of Medicine, the Department of Bioengineering (Schuman), Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania; the Cole Eye Institute (Singh, Eisenberg), Cleveland Clinic Foundation, Cleveland, Ohio; Ophthalmology Associates (Flowers, Nair), Fort Worth, Texas, USA.
authors.forename: Leela V
authors.initials: LV
authors.lastname: Raju
authors.affiliation: From the UPMC Eye Center (Knickelbein, Davis, Raju, Schuman, Conner), Department of Ophthalmology, University of Pittsburgh School of Medicine, the Department of Bioengineering (Schuman), Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania; the Cole Eye Institute (Singh, Eisenberg), Cleveland Clinic Foundation, Cleveland, Ohio; Ophthalmology Associates (Flowers, Nair), Fort Worth, Texas, USA.
authors.forename: Joel S
authors.initials: JS
authors.lastname: Schuman
authors.affiliation: From the UPMC Eye Center (Knickelbein, Davis, Raju, Schuman, Conner), Department of Ophthalmology, University of Pittsburgh School of Medicine, the Department of Bioengineering (Schuman), Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania; the Cole Eye Institute (Singh, Eisenberg), Cleveland Clinic Foundation, Cleveland, Ohio; Ophthalmology Associates (Flowers, Nair), Fort Worth, Texas, USA. Electronic address: connerip@upmc.edu.
authors.forename: Ian P
authors.initials: IP
authors.lastname: Conner
mesh_terms: D000208:Acute Disease; D015715:Corneal Edema / Q000175:diagnosis / Q000209:etiology*; D003319:Corneal Stroma / Q000473:pathology*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D006956:Hyperopia / Q000175:diagnosis / Q000209:etiology*; D007429:Intraocular Pressure / Q000502:physiology; D053685:Laser Therapy; D008875:Middle Aged; D014130:Trabeculectomy / Q000009:adverse effects*; D014792:Visual Acuity