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Post-LASIK edema-induced keratopathy (PLEK), a new name based on pathophysiology of the condition

Poster Details

First Author: V.Galvis COLOMBIA

Co Author(s):    A. Tello   M. Revelo   P. Valarezo        

Abstract Details



Purpose:

To present the case of a patient who underwent laser in situ keratomileusis (LASIK) and developed an interface complication in both eyes: in the right eye compatible with Interface Fluid Syndrome (IFS) and in the left one with Pressure-induced stromal keratopathy (PISK).This case illustrates that in the same patient a post-LASIK edema induced syndrome may be present with or without fluid in the interface, suggesting that both clinical pictures could be manifestations of a broad spectrum of the same condition. We suggest a new name for this non-inflammatory disorder: post- LASIK edema-induced keratopathy (PLEK).

Setting:

Centro Oftalmol├│gico Virgilio Galvis

Methods:

The case of a 33-year-old man who underwent uneventful laser in situ keratomileusis (LASIK) and developed pressure-induced stromal edema resulting in an interface haze in both eyes and a pocket of fluid under the flap of the right eye 10 days after surgery, is presented.

Results:

After LASIK the patient had been prescribed topical fluorometholone. 10 dyas after LASIK intraocular pressure by applanation tonometry was 16 mm Hg in his right eye (erroneous result due to the fluid in the interface) and 34 mm Hg in his left eye. After discontinuation of steroids and addition of ocular hypotensive medication, interface fluid collection disappeared in his right eye. Visual acuity improved and haze diminished in both eyes. This case illustrates that in the same patient a post-LASIK edema induced syndrome may be present with or without fluid in the interface, suggesting that both clinical pictures could be manifestations of a broad spectrum of the same condition. We reviewed the literature and found several cases not related to IOP increase but to endothelial dysnfunction, suggesting that corneal edema from any origin is the causative factor, and not only IOP increase. We suggest a new name for this non-inflammatory disorder: post-LASIK edema-induced keratopathy (PLEK).

Conclusions:

If post-laser in situ keratomileusis (LASIK) conditions known as interface fluid syndrome (IFS) and pressure-induced interlamellar keratitis (PISK) are not detected, severe visual sequelae may occur due to optic nerve damage, since usually they are related with ocular hypertension. The basic cause of IFS and PISK is not ocular hypertension but the corneal edema secondary to it. For that reason a new name is proposed: post-LASIK edema-induced keratopathy (PLEK).

Financial Disclosure:

NONE

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