Am J Ophthalmol. 2004 Oct;138(4):657-9.
Principe AH, Lin DY, Small KW, Aldave AJ.
Cornea Service, Jules Stein Eye Institute, University of California Los Angeles Medical Center, Los Angeles, California 90095, USA.
PURPOSE: To report the first case of macular hemorrhage following laser in situ keratomileusis (LASIK) with femtosecond laser flap creation.
DESIGN: Observational case report.
METHODS: A 36-year-old woman underwent uncomplicated, bilateral, simultaneous LASIK procedures for correction of moderate myopia (-5.00 diopters OD and -6.00 diopters OS). LASIK flap creation was performed using the IntraLase femtosecond laser.
RESULTS: On postoperative day 1, the patient's uncorrected and best-corrected visual acuities were 20/20 OD and 20/40 OS. A dilated fundoscopic examination revealed a one-third disk diameter macular hemorrhage OS. An intravenous fluorescein angoiogram ruled out the presence of predisposing macular pathology. Two months after LASIK, the macular hemorrhage had cleared, and 6 months later, the BCVA improved to 20/25 OS.
CONCLUSIONS: Macular hemorrhage may occur after LASIK, even in the absence of previously identified risk factors, such as high myopia, pre-existing choroidal neovasculaization, lacquer cracks, and sudden changes in intraocular pressure associated with microkeratome-assisted flap creation.