Acute Keratoconus-Like Hydrops after Laser In Situ Keratomileusis

Abstract EN

Purpose.

To demonstrate keratoconus-like hydrops after laser in situ keratomileusis (LASIK) by optical coherence tomography (OCT).

Patient and Methods.

A 21-year-old man received uneventful bilateral LASIK.

On slit lamp examination or corneal topography there were no signs of fruste keratoconus.

The preoperative corneal thickness was 587-μm OD and the calculated ablation for two treatments was 114-μm.

Uneventful LASIK with an optical zone of 7 mm and an ablation of 89-μm OD, and an ablation of 73-μm OS was performed.

Three years postoperatively, he complained about progressive myopia and impaired vision OD.

His VA was hand motion OD and 20/20 OS.

Results.

OCT and light microscopy revealed an anterior corneal steepening and acute keratoconus-like excessive edematous swelling.

Conclusion.

The cornea is mechanically weakened after LASIK by the lamellar cut and tissue subtraction.

Although the advocated minimal residual stromal bed thickness is 250-μm, it may not be adequate to prevent progressive keratoconus-like hydrops in the selected cases.