Bilateral Macular Holes After LASIK for Myopia
Bilateral Macular Holes After LASIK for Myopia
Introduction. Laser-assisted in situ keratomileusis surgery may induce postoperative changes in the vitreomacular interface due to the mechanical stretch of the vitreous produced by the suction ring and the shock waves generated by the excimer laser and, subsequently, may provoke macular hole formation.
Case Presentation. A 53-year-old Spanish woman who had undergone a laser-assisted in situ keratomileusis for the correction of myopia in her right and left eye (10 years ago) was referred to our department with a complaint of decreased visual acuity in both eyes. A fundoscopy and optical coherence tomography examination revealed a bilateral full-thickness macular hole. A 23-gauge sutureless pars plana vitrectomy was performed in both eyes, and 1 month after surgery her visual acuity improved and the hole closed.
Conclusion. The development of a bilateral full-thickness macular hole after laser-assisted in situ keratomileusis has been reported once. This case study enhances our understanding of the vitreoretinal pathology induced by laser-assisted in situ keratomileusis, showing the importance of a rigorous follow-up, because complications may occur even a decade later. In this case study we must also consider the contribution of the underlying myopia to the development of the bilateral macular holes.
There are several reports in the literature about vitreoretinal pathologic conditions after laser-assisted in situ keratomileusis (LASIK) for the correction of myopia. These include endophthalmitis, macular holes, retinal tears and detachments, retinal hemorrhages, and choroidal neovascular membranes.
Although a few papers have reported anatomic and functional outcomes after vitreoretinal surgery for the correction of unilateral full-thickness macular holes (FTMH) developing after bilateral LASIK, only one describes a patient who presented with bilateral holes after refractive laser surgery. We report the results of a vitrectomy in a myopic patient who developed a bilateral FTMH after LASIK.
Abstract and Introduction
Abstract
Introduction. Laser-assisted in situ keratomileusis surgery may induce postoperative changes in the vitreomacular interface due to the mechanical stretch of the vitreous produced by the suction ring and the shock waves generated by the excimer laser and, subsequently, may provoke macular hole formation.
Case Presentation. A 53-year-old Spanish woman who had undergone a laser-assisted in situ keratomileusis for the correction of myopia in her right and left eye (10 years ago) was referred to our department with a complaint of decreased visual acuity in both eyes. A fundoscopy and optical coherence tomography examination revealed a bilateral full-thickness macular hole. A 23-gauge sutureless pars plana vitrectomy was performed in both eyes, and 1 month after surgery her visual acuity improved and the hole closed.
Conclusion. The development of a bilateral full-thickness macular hole after laser-assisted in situ keratomileusis has been reported once. This case study enhances our understanding of the vitreoretinal pathology induced by laser-assisted in situ keratomileusis, showing the importance of a rigorous follow-up, because complications may occur even a decade later. In this case study we must also consider the contribution of the underlying myopia to the development of the bilateral macular holes.
Introduction
There are several reports in the literature about vitreoretinal pathologic conditions after laser-assisted in situ keratomileusis (LASIK) for the correction of myopia. These include endophthalmitis, macular holes, retinal tears and detachments, retinal hemorrhages, and choroidal neovascular membranes.
Although a few papers have reported anatomic and functional outcomes after vitreoretinal surgery for the correction of unilateral full-thickness macular holes (FTMH) developing after bilateral LASIK, only one describes a patient who presented with bilateral holes after refractive laser surgery. We report the results of a vitrectomy in a myopic patient who developed a bilateral FTMH after LASIK.
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