A Case Report: Lipid Keratopathy After Refractive Surgery

To share a rare case of  Lipid keratopathy after  LASIK surgery.

A 43-year-old women who was underwent a binocular “Femtosecond Assisted LASIK surgery” were followed-up 3 years.

A 43-year-old women underwent a binocular “Femtosecond Assisted LASIK surgery” because of myopia and presbyopia on 2020-12-24. Preoperative examinations were normal. NO evidence of previous ocular disease or systemic disorder. The surgery went well, and postoperative results were good. Postoperative 1 month, decreased vision, photophobia, foreign body sensation, and corneal edema of right eye were occurred. Corticosteroids was available, but there were no regularly followed up. Postoperative 7 months, the above symptoms were aggravated. Corneal neovascularization appeared in the superficial stromal of superior temporal cornea. Lipid deposition at the ends of neovascular vessels encroached on the central cornea(Fig-1). The lens, ocular fundi, and intraocular pressure were normal. The treatments were corticosteroids and regularly following up. The clinical manifestations suggested it is Lipid keratopathy(LK). The cause of idiopathic LK is unknown, and this form occurs bilaterally. Secondary LK occurs secondary to a disease or trauma to the eye and is typically unilateral. Although there were some reports of secondary LK, there are few reports secondary to femtosecond LASIK surgery. In this case, although corticosteroids were available, further following up and more robust, reliable and precise treatments must be performed to this patient.

LK after Fs-LASIK is rare. Both the mechanism and treatment are worth exploring.