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SURGICAL SKILLS TRAININGFirst Author: JovanaSuvajac SERBIA
Co Author(s): Marina Marković Vladimir Suvajac Vesna Novaković Kristina Savić Gordana Suvajac
Purpose:
To present a patient with pressure induced intralamellar stromal keratitis (PISK) after laser in situ Keratomileusis (LASIK).
Setting:
: Eye Clinic "Profesional - dr Suvajac"
Methods:
Case report
Results:
We report a case of intralamellar stromal keratitis, induced by elevated intraocular pressure (IOP) after LASIK. On the twelfth postoperative day, 33-year-old man, complained of blurry vision, discomfort and pain in the orbital region. The slit lamp exam showed DLK- like interface opacity. The measured IOP was 40 mmHg. Topical corticosteroid therapy was immediately excluded and the patient was treated with both systemic and local antiglaucomatous therapy. Visual acuity and slit lamp microscopy showed significant improvement after lowering the IOP and cessation of topical steroids.
Conclusions:
This case emphasizes the importance of measuring the IOP when DLK-like picture occurs after the first postoperative week. PISK mimics the appearance of DLK, and it is extremely important not to mix up these two entities, because the corticosteroid treatment of DLK worsens the haze, IOP raises and significant, irreversible changes can occur. An early recognition and normalizing the IOP can prevent significant visual acuity loss, visual field defects, and severe glaucomatous optic neuropathy. FINANCIAL INTEREST: NONE