Resumen de Delayed acute optic neuropathies following LASIK

Rafael Bilbao Calabuig, Eva López Valdés, Felix Gonzalez Lopez, Fernando Llovet Osuna

• PURPOSE: To report 2 cases of delayed acute optic neuropathy following LASIK.

  METHODS: 2 patients developed unilateral decrease in visual field and visual acuity with optic disk edema, 5 and 20 days after uneventful bilateral myopic LASIK surgery. We evidenced sequential changes in their peripapilar retinal nerve fiber layer thickness assessed by optical coherence tomography and their central visual fields. Both patients had evaluation for alternative etiologies of their optic neuropathy.

  RESULTS: The former patient suffered an ischemic anterior optic neuropathy secondary to a severe acute steroid-induced ocular hypertension, and the latter an optic neuritis as the initial manifestation of a demyeliniating disease, accidentally occurring just after the refractive procedure.

  CONCLUSIONS: Patients who have LASIK may rarely experience an acute optic neuropathy;

  although the most described mechanism is barotrauma or ischemia related to extreme elevation of intraocular pressure by the suction ring, other causes, as in our patients, may induce the nerve damage.