Early rhegmatogenous retinal detachment following laser in situ keratomileusis for high myopia

PURPOSE: Four eyes had early rhegmatogenous retinal detachment within 3 mon ths of laser in situ keratomileusis (LASIK) for correction of high myopia u sing the microkeratome, Clear Corneal Molder. METHODS: In two eyes, retinal detachment resulted from horseshoe tears, one occurring in an otherwise normal region of the retina and the other at the margin of an area of lattice degeneration detected during preoperative exa mination. The first eye was treated with retinopexy using a 287 encircling scleral exoplant, drainage of subretinal fluid, and laser photocoagulation by indirect ophthalmoscopy. The other eye was treated with pneumatic retino pexy and cryotherapy. In the other eyes, retinal detachment was the result of giant tears with no evidence of prior retinal degeneration. These eyes w ere treated with pars plans vitrectomy, fluid-gas exchange with 15% perfluo ropropane (C3F8), endolaser photocoagulation, and a 42 encircling scleral e xoplant. RESULTS: After treatment, the first two eyes achieved spectacle-corrected v isual acuity of 20/40. In the last two eyes, final spectacle-corrected visu al acuity was 20/400 in one eye and light perception in the other. CONCLUSIONS: Although no cause-effect relationship between LASIK and retina l detachment can be stated, these cases suggest that LASIK may be associate d with retinal detachment, particularly in highly myopic eyes. Further stud ies are necessary to determine high-risk patient characteristics.