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Chapter-15 Chan's and Boxer Wachler's LASIK Complications

BOOK TITLE: Lasik and Lasik Complications

Author
1. Chan Colin CK
2. Wachler B Boxer
ISBN
9788184482324
DOI
10.5005/jp/books/10443_15
Edition
1/e
Publishing Year
2008
Pages
6
Author Affiliations
1. The Eye Institute, Sydney, Australia, The Eye Institute, Chastwood, NSW, Australia
2. Los Angeles, CA – USA
Chapter keywords

Abstract

Wavefront re-treatment for higher order aberrations post-conventional Lasik: A 39 years old man with preoperative manifest refraction in OD – 11, 50 – 5,00 × 6 yielding 20/30 and in OS – 10, 75 –2, 50 × 17 yielding 20/30, mildly amblyopic in the right eye, after conventional myopic Lasik, complained of haloes and double vision OU. 6 years later and post 3 enhancements, manifest refraction was OD –1,00 × 140?20/30 and OS – 2, 25 – 0, 25 × 45?20/25. Pachymetry was OD 426 and OS 482. Corneal topographies: myopic ablation zones smaller. At slit-lamp examination: small flaps and mild central scarring in both eyes. Wavefront maps: increased higher order aberrations. Surgical tips: perform a surface ablation given reduced corneal thickness; wavefront re-treatments are prone to overcorrection. A second conventional laser treatment may be necessary to correct any residual error. At 3 months, patient’s symptoms and higher order aberrations reduced considerably. Treatment of post-lasik ectasia: a 25 years old man with deteriorating vision, halos and distortion 3 years after conventional myopic Lasik. His pre-Lasik manifest refraction was: RE – 2, 25 and LE – 2,00; corneal topography: inferior steepening OU; at slit-lamp examination: mild corneal scars. Conclusion: keratoectasia post Lasik, C3-R performed in both eyes. Patients with ectasia may complain with decreased vision, night visual disturbances and distortion, also fluctuating vision for an unstable cornea. Placement of a single segment is more appropriate than double segment for post Lasik ectasia. The patient gained 4-lines of BCVA in RE and 1-lines in LE due to the topographic improvement and manifest refraction continue to be stable at 9 months follow-up.

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