S E Ti1, D T Tan. 1. Singapore National Eye Center, Singapore. snectse@pacific.net.sg
Abstract
PURPOSE: To describe how laser-assisted in situ keratomileusis (LASIK) may induce recurrent corneal erosion (RCE) syndrome and the preventive measures for avoiding this complication. METHODS. A case series was used. RESULTS: We report the development of RCE syndrome in eight eyes of six patients after LASIK. In five cases, the RCE was triggered by epithelial trauma at the time of the LASIK procedure, as evidenced by the observation of RCE occurring at the same site as the initial epithelial disturbance. In case 6, RCE occurred with undiagnosed basement membrane dystrophy. The patients responded to treatment with ocular lubricants with one patient undergoing penetrating keratoplasty for RCE after LASIK. CONCLUSION: LASIK can induce or precipitate RCE, and RCE should perhaps be included as a potential complication in the informed consent process. It is important to minimize epithelial damage to prevent RCE after LASIK, and measures to reduce this include adequate irrigation of the corneal surface immediately before the microkeratome pass and careful attention to flap epithelium during flap replacement. Cases in which loose epithelium is noted after LASIK should be identified as potential RCE cases, and extra care should be taken for subsequent enhancement procedures or LASIK of the second eye.
PURPOSE: To describe how laser-assisted in situ keratomileusis (LASIK) may induce recurrent corneal erosion (RCE) syndrome and the preventive measures for avoiding this complication. METHODS. A case series was used. RESULTS: We report the development of RCE syndrome in eight eyes of six patients after LASIK. In five cases, the RCE was triggered by epithelial trauma at the time of the LASIK procedure, as evidenced by the observation of RCE occurring at the same site as the initial epithelial disturbance. In case 6, RCE occurred with undiagnosed basement membrane dystrophy. The patients responded to treatment with ocular lubricants with one patient undergoing penetrating keratoplasty for RCE after LASIK. CONCLUSION: LASIK can induce or precipitate RCE, and RCE should perhaps be included as a potential complication in the informed consent process. It is important to minimize epithelial damage to prevent RCE after LASIK, and measures to reduce this include adequate irrigation of the corneal surface immediately before the microkeratome pass and careful attention to flap epithelium during flap replacement. Cases in which loose epithelium is noted after LASIK should be identified as potential RCE cases, and extra care should be taken for subsequent enhancement procedures or LASIK of the second eye.