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.