J Korean Ophthalmol Soc.  2017 Mar;58(3):337-341. 10.3341/jkos.2017.58.3.337.

Management of Complication after Hyperopic Laser-assisted in-situ Keratomileusis

• Jo J
• Park JH
• Tchah HW
• Kim MJ

• KMID: 2371916
• DOI: http://doi.org/10.3341/jkos.2017.58.3.337

Abstract

PURPOSE
We present a case of a patient who underwent corneal refractive surgery to improve their corrected visual acuity due to a complication of hyperopic laser-assisted in-situ keratomileusis (LASIK).
CASE SUMMARY
The patient complained of decreased vision after hyperopic LASIK surgery 12 years prior. The corrected distance visual acuity (CDVA) was 20/200 in the right eye and 20/32 in the left, with manifested refractions of +1.25 +2.00 × 90 and -0.25 +2.00 × 80, respectively. The patient had a with-the-rule astigmatism. The values of corneal and total spherical aberration, which can be determined as coefficients of the Zernike polynomials, were respectively -1.027 µm and -0.773 µm in the right eye and -0.965 µm and -0.881 µm in the left eye. Slit lamp biomicroscopy revealed no remarkable findings. We performed surface ablation surgery to flatten the central cornea of the patient's right eye. At 12 months after surgery, the CDVA of the patient's right eye was 20/30 and the negative corneal spherical aberration was reduced.
CONCLUSIONS
Corneal refractive surgery to reduce negative corneal spherical aberration by flattening the central cornea is one of possible treatment options for the reduced corrected distance visual acuity after hyperopic LASIK.

Keyword

Complication; Hyperopic laser-assisted in-situ keratomileusis (LASIK); Laser refractive surgery

MeSH Terms

Astigmatism
Cornea
Humans
Keratomileusis, Laser In Situ
Patient Rights
Refractive Surgical Procedures
Slit Lamp
Visual Acuity

Figure

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  Figure 1. Topographic and tomographic findings of the patient after hyperopic laser-assisted in-situ keratomileusis (LASIK) using Orbscan II. (A) Right eye of the patient. (B) Left eye of the patient. T = temporal; N = nasal; OD = oculus dexter; OS = oculus sinister.

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  Figure 2. Postoperative findings of Orbscan. Central cornea has been flattened after laser refractive surgery. T = temporal; N = na-sal; OD = oculus dexter.

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