Posters

Corneal neuralgia after LASIK

Poster Details

First Author: M.Ayoubi UK

Co Author(s): J. Masood   S. Nowak                 

Abstract Details

Purpose:

To question the scientific definition of Corneal Neuralgia after uncomplicated Lasik Femtosecond treatment . And to try to describe a need to draw a line in differentiating between post lasik dry eye and cornel neuralgia .

Setting:

Ultralase and Optimax Refractive Surgeries Clinics UK

Methods:

53 year old lady had Lasik hypermetropic intralase treatment , she had a history of mild dryness related to contact lens wear before treatment , she had treatment for her dry eyes for 6 months before Lasik treatment , she had normal TBUT on the treatment day . She developed dry eyes symptoms post Lasik with TBUT between 5-10 seconds recorded on different clinical visits up to 18 months from lasik treatment . She was treated with all type of dry eye treatments including steroid  cyclosporine , different artificial tear drops , punctuated plugs, and even mibo-flow to treat her blepharitis

Results:

Confocal microscopy was performed as her dry eye symptoms persists in a form of ocular discomfort and pain especially in the right eye and radiates to the right temple side which is tender to touch ? The in Vivo confocal microscopy demonstrates moderate diminished of corneal nerves , increased tortuosity, beading, and increased presence of immune dendritic cells especially in the left eye . As the clinical signs are inconsistent with the level of discomfort she is experiencing , a form of corneal neuralgia after lasik was suggested , Treatment with Autologous Serum was given four times daily .

Conclusions:

Dry eye symptoms are not uncommon after Lasik treatment , and these usually tend to improve with time ,majority of patient report complete improvements by 18 months post Lasik treatment . However in case of persistent dry eye complains , confocal microscopy test is recommended , this patient confocal microscopy is consistent with what expected after Lasik treatment . we suggest  it is important that a proper definition of corneal neuralgia is established before such diagnosis is suggested . such as specific corneal nerve shapes on confocal microscopy or duration or severity of symptoms .

Financial Disclosure:

None