Optic neuropathy associated with laser in situ keratomileusis

Purpose: To report 4 cases of optic neuropathy following laser in situ kera tomileusis (LASIK). Setting: Tertiary care ophthalmic practices. Methods: In this retrospective observational case series, 4 patients who de veloped acute visual loss following LASIK are reported. All had clinical ev idence of optic neuropathy. Two had optic disc edema and 2 had normal appea ring optic discs initially. None of the patients experienced significant vi sual recovery, and all developed optic atrophy in the affected eye. Results: All patients had evaluations for alternative etiologies of their o ptic neuropathy, with negative results. All patients were therefore presume d to have experienced an ischemic optic neuropathy following LASIK. Conclusions: Patients who have LASIK may experience an acute anterior or re trobulbar optic neuropathy. The etiology is unknown but may be related to t he marked increase in intraocular pressure that occurs during a portion of the procedure. J Cataract Refract Surg 2000; 26:1581-1584 (C) 2000 ASCRS an d ESCRS.