Retinal detachment in myopic eyes after laser in situ keratomileusis

PURPOSE: To analyze the incidence and characteristics of retinal detachment in myopic patients treated by laser-assisted in situ keratomileusis. METHODS: We retrospectively studied the retinal detachments observed in 1,5 54 consecutive eyes (878 patients) undergoing laser-assisted in situ kerato mileusis for the correction of myopia (follow-up, 30.34 +/- 10.27 months; r ange, 16 to 54). Mean patient age was 33.09 +/- 8.6 years (range, 20 to 60) . Before treatment with laser-assisted in situ keratomileusis, all patients had a comprehensive examination, and detected lesions predisposing to reti nal detachment were treated before performing the laser-assisted in situ ke ratomileusis procedure. RESULTS: Retinal detachment occurred in four (0.25%) of 1,554 eyes of four (0.45%) of 878 patients. All four patients who developed retinal detachment in one eye were women. Degree of preoperative myopia was -13.52 +/- 3.38 d iopters (range, -8.00 to -27.50). The time interval between refractive surg ery and retinal detachment was 11.25 +/- 8.53 months (range, 2 to 19 months ). In all cases retinal detachment was spontaneous. In all eyes the retina was reattached successfully at the first retinal detachment surgery. Mean b est-corrected visual acuity after laser-assisted in situ keratomileusis and before retinal detachment development was 20/43 (range, 20/50 to 20/30). A fter retinal detachment repair, best-corrected visual acuity was 20/45 (ran ge, 20/50 to 20/32). Differences between best-corrected visual acuity befor e and after reattachment were not statistically significant (P = .21, paire d Student t test). A myopic shift was induced in three eyes that had retina l detachment repaired by scleral buckling, from -0.58 +/- 0.72 diopter (ran ge, +0.25 to -1.00) before retinal detachment and -2.25 +/- 1.14 diopters ( range, -1.00 to -3.25) after retinal detachment surgery (P = .03, paired St udent t test). CONCLUSIONS: Laser-assisted in situ keratomileusis for correction of myopia is followed by a low incidence of retinal detachment. Conventional scleral buckling surgery was successful in most cases and did not cause significan t changes in the final best-corrected visual acuity. A significant increase in the myopic spherical equivalent was observed after scleral buckling in these patients. (C) 1999 by Elsevier Science Inc. All rights reserved.