http://www.osnsupersite.com

OCULAR SURGERY NEWS 10/1/2004

Excerpt:

Some users of the IntraLase femtosecond laser keratome first noticed the complication when they began working with the system more than 2 years ago. Since then, the phenomenon has gone under multiple names.

“Patients would walk into the office with two pairs of sunglasses on and a baseball cap,” said Brian R. Will, MD, director of Will Vision & Laser Centers in Vancouver, Wash. “No one knew what to make of the symptoms — light sensitivity, preserved visual acuity and no slit-lamp findings.”

Dr. Will coined the term track-related iridocyclitis and scleritis (TRISC) syndrome to describe the condition he thought was due to gas bubbles and debris migrating toward the limbus during LASIK with IntraLase.

Karl G. Stonecipher, MD, another early user of IntraLase, called the syndrome good acuity plus photophobia (GAPP). “It’s similar to the late-onset inflammation we once saw with PRK,” Dr. Stonecipher, of Greensboro, N.C., told Ocular Surgery News. He believed that the inflammation was due to activated keratocytes in the interface.

As time passed, speculation grew among users. Surgeons became concerned about the cause and identity of the rare aftereffect of IntraLase flap creation.

“It was scary when we didn’t know what it was — frightening to the surgeon and the patient,” said Daniel S. Durrie, MD, director of Durrie Vision in Overland Park, Kan.

In July, IntraLase surveyed users of its system and discovered that the apparent photophobia phenomenon was unique to LASIK cases using IntraLase for creation of the flap.

“Transient light sensitivity, or TLS, is the term coined by IntraLase to describe the complication,” Dr. Durrie said.