2020–2021 BCSC Basic and Clinical Science Course™
13 Refractive Surgery
Chapter 6: Photoablation: Complications and Adverse Effects
Rare, sometimes coincidental, complications of LASIK include optic nerve ischemia, premacular subhyaloid hemorrhage, macular hemorrhage associated with preexisting lacquer cracks or choroidal neovascularization, choroidal infarcts, postoperative corneal edema associated with preoperative cornea guttata, and ring scotoma. Diplopia is another rare complication that may occur in patients whose refractive error has been corrected and who have iatrogenic monovision, improper control of accommodation (in patients with strabismus), or decompensated phorias.
Gimbel HV, Penno EE, van Westenbrugge JA, Ferensowicz M, Furlong MT. Incidence and management of intraoperative and early postoperative complications in 1000 consecutive laser in situ keratomileusis cases. Ophthalmology. 1998;105(10):1839–1848.
Gunton KB, Armstrong B. Diplopia in adult patients following cataract extraction and refractive surgery. Curr Opin Ophthalmol. 2010;21(5):341–344.
Moshirfar M, Feiz V, Feilmeier MR, Kang PC. Laser in situ keratomileusis in patients with corneal guttata and family history of Fuchs’ endothelial dystrophy. J Cataract Refract Surg. 2005;31(12):2281–2296.
Netto MV, Dupps W Jr, Wilson SE. Wavefront-guided ablation: evidence for efficacy compared to traditional ablation. Am J Ophthalmol. 2006;141(2):360–368.
Stulting RD, Carr JD, Thompson KP, Waring GO III, Wiley WM, Walker JG. Complications of laser in situ keratomileusis for the correction of myopia. Ophthalmology. 1999;106(1): 13–20.
Sugar A, Rapuano CJ, Culbertson WW, et al. Laser in situ keratomileusis for myopia and astigmatism: safety and efficacy: a report by the American Academy of Ophthalmology. Ophthalmology. 2002;109(1):175–187.
Excerpted from BCSC 2020-2021 series: Section 13 - Refractive Surgery. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.