Pharmacologic Management of Pressure-Induced Stromal Keratopathy after LASIK

Optom Vis Sci. 2016 Jul;93(7):757-9. doi: 10.1097/OPX.0000000000000853.

Abstract

Purpose: To emphasize the importance of anticipation of pressure-induced stromal keratopathy (PISK) in eyes with a previous history of LASIK.

Case report: A 40-year-old man developed LASIK-related pressure-induced stromal keratopathy after uneventful phacoemulsification (Phaco) and intraocular lens (IOL) implantation in his left eye. With immediate discontinuation of the steroid drops and initiation of antiglaucoma medication, his visual acuity, interface edema, and haze improved rapidly. One year later, during Phaco with IOL implantation in his other eye, with anticipation of a similar LASIK-related pressure-induced stromal keratopathy, a very brief course of soft steroid therapy was given together with antiglaucoma medication. Intraocular pressure elevation was avoided, and no interface edema or haze was observed.

Conclusions: This case illustrates that the risk for LASIK-related pressure-induced stromal keratopathy may be reduced with appropriate precautions.

Publication types

  • Case Reports

MeSH terms

  • Acetazolamide / therapeutic use
  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Brimonidine Tartrate, Timolol Maleate Drug Combination / therapeutic use
  • Corneal Edema / drug therapy*
  • Corneal Edema / etiology
  • Corneal Stroma / drug effects*
  • Corneal Stroma / pathology
  • Diuretics / therapeutic use
  • Humans
  • Intraocular Pressure / drug effects*
  • Keratomileusis, Laser In Situ*
  • Lens Implantation, Intraocular
  • Male
  • Ocular Hypertension / drug therapy*
  • Ocular Hypertension / etiology
  • Phacoemulsification
  • Postoperative Complications*
  • Visual Acuity

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antihypertensive Agents
  • Brimonidine Tartrate, Timolol Maleate Drug Combination
  • Diuretics
  • Acetazolamide