Corneal perforation during laser in situ keratomileusis after hyperopic electrothermal keratoplasty

María M. Silva-Díaz, Ashley Behrens, Francia Y. Torres, Gustavo Carstens, María A. Benavides, Enrique Suárez

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Abstract

PURPOSE: To report a corneal perforation during laser in situ keratomileusis (LASIK) after previous electrothermokeratoplasty. DESIGN: Interventional case report. METHODS: A 49-year-old man presented with primary hyperopia in the right eye and residual hyperopia after electrothermokeratoplasty in the left eye. His refraction was +4.00 in the right eye and +7.00 -3.00 × 135 degrees in the left eye, with a central pachymetry of 535 μm and 549 μm, respectively. Phacoemulsification with intraocular lens (IOL) insertion in the right eye and a two-step keratophacorefractive procedure with a piggyback IOL insertion and LASIK in the left eye were proposed. RESULTS: Postoperative refraction was -0.50 -0.50 × 150 degrees 20/20 in the right eye. Postphacoemulsifi-cation refraction was -4.75 -4.25 × 135 degrees in the left eye. Laser in situ keratomileusis was performed in the left eye, 4 months later, with uneventful astigmatic laser ablation. During the myopic ablation, a sudden outcome of aqueous humor in one of the temporal corneal scars was observed. CONCLUSIONS: Unpredictably thin areas after electrothermokeratoplasty may lead to unexpected corneal perforation during LASIK. The available pachymetry systems may be unreliable after electrothermal keratoplasty.

Original languageEnglish (US)
Pages (from-to)554-557
Number of pages4
JournalAmerican Journal of Ophthalmology
Volume135
Issue number4
DOIs
Publication statusPublished - Apr 1 2003
Externally publishedYes

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ASJC Scopus subject areas

  • Ophthalmology

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