Fine lattice lines on the corneal surface after laser in situ keratomileusis (LASIK)

PURPOSE: To present an example of a pattern of lines resembling fine lattic e on the corneal surface subsequent to laser in situ keratomileusis (LASIK) . This subtle phenomenon may be relatively common and may affect visual out come. METHOD: Case report. RESULTS: A 41-year-old year old man with high myopia and best-corrected vis ual acuity of 20/20 +2 in each eye underwent laser in situ keratomileusis ( LASIK), No operative or postoperative complications occurred, No striae wer e evident on slit-lamp examination with direct illumination and retroillumi nation at the time of surgery or in the postoperative period. Postoperative uncorrected visual acuity was 20/25 with a best-corrected spectacle correc tion of 20/25 in both eyes. Fine lines in a lattice pattern were seen only with fluorescein dye in. the precorneal tear film as areas of "negative sta in" within the LASIK flap. With tear film supplementation, the lines were l ess evident and visual acuity improved. One year postoperatively, his uncor rected visual acuity was 20/25 in both eyes. The best-corrected spectacle v isual acuity was RE: 20/20 -2, LE: 20/25, The fine lines were still present within the flap. A soft contact lens improved visual acuity to 20/20 in bo th eyes. Although all four puncta were occluded, he had no epiphora, CONCLUSION: Fine lines in a lattice pattern that may represent folds in the epithelium or Bowman layer may be present within the flap after LASIK and may adversely affect visual acuity, They may be visible as areas of negativ e stain with fluorescein dye in the precorneal tear film in the absence of any striae visible in the flap, These superficial lines have been seen more in patients with high degrees of correction and in patients with dry eye, If visual acuity is affected, it may be improved with punctal occlusion, te ar supplements, or a contact lens. (C) 2000 by Elsevier Science Inc. All ri ghts reserved.