American
Journal of Ophthalmology
Volume
138, Issue 6, December 2004, Pages 1069-1071
Arun Singhvi MD, Mayank Dutta MBBS,
Namrata Sharma MD, Nikhil Pal MD
and Rasik B. Vajpayee MS, FRCSEd,
Rajendra Prasad Centre for Ophthalmic Sciences,
All India Institute of Medical Sciences, New Delhi, India.
Purpose
To report a case of bilateral serous macular detachment following laser in situ keratomileusis (LASIK).
Design
Observational case report.
Methods
A 33-year-old man presented with sudden decrease of vision in both eyes 4 days following uncomplicated LASIK in both eyes for spherical equivalent of +5.00 diopters sph in the right eye and +7.00 diopters sph in the left eye. Detailed history with ocular and systemic examination, fluorescein angiography, and optical coherence tomography were done. Retinal examination had a documentation of retinal pigment epithelium atrophy in the macular region in both eyes pre-LASIK.
Results
A diagnosis of central serous chorioretinopathy (CSCR) was made in both eyes, with multifocal alterations in the retinal pigment epithelium and a pocket of serous retinal fluid in the macular region confirmed on OCT. Late venous phase of fluorescein angiogram demonstrated multiple hyperfluorescent foci of leakage, more in the right eye with areas of retinal pigment epithelium staining.
Conclusions
Preexisting macular pathology, such as retinal pigment epithelium atrophy could be a new contraindication to LASIK for hypermetropia with possible development of CSCR, requiring a careful examination of the fundus pre-LASIK.
Posted by Admin at December 1, 2004 06:09 PM