Localized Midperipheral Corneal Steepening after Hyperopic LASIK following Radial Keratotomy

Publisher Website
Google Scholar
Abstract
To describe a case of localized midperipheral corneal steepening after laser in situ keratomileusis (LASIK) to correct hyperopia induced by radial keratotomy (RK) overcorrection. A retrospective case observation of an unusual case. Five years after bilateral RK (with eight incisions) performed out of the country, a 43-year-old woman underwent LASIK in her right eye. Preoperatively, manifest refraction was + 7.75 – 1.00 × 104. Four months after LASIK, the patient's UCVA was 20/70, manifest refraction was + 2.25 – 1.25 × 103, and LASIK enhancement with flap recutting was performed. One month later, the patient complained of a 1-day history of pain and photophobia. UCVA was 20/40, and a RK incision had opened. The eye was covered with a bandage contact lens (BCL) and TobraDex® drops prescribed. The following day, the BCL was removed, and UCVA was 20/200. Four days later, the patient's UCVA was 20/25. Five and a half months after LASIK enhancement, the dehisced RK incision was closed, UCVA was 20/30, and manifest refraction was + 1.25 – 1.25 × 85. One year after enhancement, UCVA deteriorated to 20/70 with manifest refraction of − 1.00 – 1.25 × 40. Localized midperipheral corneal steepening on topography also seemed to be developing. In LASIK surgery after RK, there is an inherent weakness of the cornea. Although visual acuity after RK-induced hyperopia may be improved by LASIK, the long-term refractive stability of the procedure is uncertain. Patients who undergo such a procedure should be monitored for developing localized midperipheral corneal steepening and be informed that such a complication can occur.