Central island formation after cataract surgery in a laser in situ keratomileusis eye: New etiology

Disturbances of the stromal microstructure occurring in refractive surgical procedures may create unexpected and undesired changes to the vision quality of the eye. Examples of common procedures which can profoundly alter the integrity of the stroma include laser ablation techniques such as Laser in situ keratomileusis (LASIK) for treating myopia, hyperopia and astigmatism, scleral incisions for lens extraction in cataract surgery and conducting keratoplasty (CK) for the treatment of hyperopia and presbyopia. The stroma is the primary load-carrying layer of the cornea and in the normal eye it is in a state of tension resulting from the intraocular pressure (IOP). When a surgical procedure disrupts the stromal tissue, the stresses in the tissue will be redistributed inducing what may be called the biomechanical response of the tissue to the surgical procedure. In the case of LASIK and CK, for example, surgeons wish to change the optical power of the cornea by reshaping the anterior surface. Biomechanically induced deformations may cause the achieved power to deviate from the planned correction and may also introduce aberrations in the resulting optical path. In contrast, in cataract surgery, surgeons may wish to preserve the original power of the cornea and in this case biomechanical deformations may defeat this objective.

Download Full-text

Laser in situ keratomileusis for refractive error after cataract surgery

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2004.08.054 ◽

2005 ◽

Vol 31 (5) ◽

pp. 979-986 ◽

Cited By ~ 32

Author(s):

Peter Kim ◽

Esther M. Briganti ◽

Gerard L. Sutton ◽

Michael A. Lawless ◽

Christopher M. Rogers ◽

...

Keyword(s):

Cataract Surgery ◽

Refractive Error ◽

Laser In Situ Keratomileusis

Download Full-text

Interface fluid syndrome secondary to endothelial failure due to toxic anterior segment syndrome after cataract surgery

European Journal of Ophthalmology ◽

10.1177/1120672118800241 ◽

2018 ◽

Vol 29 (3) ◽

pp. NP1-NP4

Author(s):

Burcu Kasım ◽

Yusuf Koçluk ◽

Ayşe Burcu

Keyword(s):

Cataract Surgery ◽

Cell Function ◽

Anterior Segment ◽

Laser In Situ Keratomileusis ◽

Blurred Vision ◽

Endothelial Cell Function ◽

History Of ◽

Toxic Anterior Segment Syndrome ◽

The Right

Purpose: To present a case of previous laser in situ keratomileusis with interface fluid syndrome secondary to toxic anterior segment syndrome following cataract surgery. Case report: A 52-year-old woman, complaining blurred vision in her right eye for 18 months after cataract surgery, was referred to our clinic. She was diagnosed with toxic anterior segment syndrome, postoperatively, which resolved in 3 days. She had a history of laser in situ keratomileusis surgery 15 years ago. Slit-lamp examination of the right eye showed corneal haze, limited to laser in situ keratomileusis flap. The patient was diagnosed with interface fluid syndrome secondary to endothelial decompensation due to toxic anterior segment syndrome. Descemet’s membrane endothelial keratoplasy was performed along with full thickness fenestrations in the laser in situ keratomileusis flap to the right eye of the patient. The fluid was resolved in 1 week and visual acuity was improved rapidly. Conclusion: This case shows the importance of considering the diagnosis and determining the specific etiology of interface fluid syndrome, even years after the laser in situ keratomileusis surgery, when endothelial cell function has been compromised with any factor, such as intraocular surgery and its complications.

Download Full-text