CENTRAL FOCAL INTERFACE OPACITY AFTER LASER IN-SITU KERATOMILEUSIS

BACKGROUND: The acute onset of a focal central interface opacity with visual loss following LASIK has not been described in the peer reviewe d literature. Non-peer reviewed reports of various inflammatory lesion s have been recorded. METHODS: We describe three cases in which an acu te focal stromal interface opacification was identified within 1 week of laser in situ keratomileusis (LASIK). Each case was performed by a different surgeon on a different day, but using the same method, mater ials, and the Summit Apex Plus excimer laser. Immediately after surger y, all eyes were normal with good unaided vision. The appearance of th e central stromal opacity was associated with acute visual deteriorati on. Preoperative and postoperative cycloplegic refractions, videokerat ography, and postoperative slit-lamp biomicroscopy were performed. Eac h case was treated with intensive topical corticosteroids. RESULTS: Ea ch case demonstrated a central circular opacity in the interface betwe en corneal flap and stromal bed, with associated variable stromal thin ning. Resolution of the pathological process followed 2 to 4 weeks of treatment with topical corticosteroids and subsequent improvement in s lit-lamp biomicroscopy, corneal topography, and vision. Etiology was u ncertain. CONCLUSION: Central interface opacification is a rare but vi sually important inflammatory complication of LASIK.