Pressure-induced stromal keratopathy after laser-assisted In situ keratomileusis with high intraocular pressure in disguise

• Main Authors: K S Siddharthan, C M Pooja, G V Prabhakar
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: TNOA Journal of Ophthalmic Science and Research
• Subjects: laser-assisted in situ keratomileusis; optical coherence tomography; pressure-induced stromal keratopathy; rebound tonometry
• Online Access: http://www.tnoajosr.com/article.asp?issn=2589-4528;year=2020;volume=58;issue=1;spage=27;epage=29;aulast=Siddharthan
• ISSN: 2589-4528; 2589-4536

Here, we report the case of a 28-year-old male patient who underwent uncomplicated laser-assisted in-situ keratomileusis (LASIK) in both eyes 10 days earlier and came with complaints of blurring of vision in the left eye with vision of 20/20. The patient gave a history of not tapering steroids as advised. His intraocular pressure (IOP) measured with rebound tonometer was 15 mmHg in the right eye and 25 mmHg in the left eye. On slit-lamp examination, the LASIK flap was intact in both the eyes, but the cornea appeared hazy in the left eye. Optical coherence tomography shows a central thickness of 524 μ in the left eye. The patient was diagnosed to have pressure-induced stromal keratopathy. The patient was switched to low-potency steroids, and anti-glaucoma drugs were given. On follow-up on slit-lamp examination, there was a significant decrease in haze in the left eye clear vision of 20/20 in both the eyes. It is important to recognize and treat PISK appropriately, as untreated elevated IOP can lead to optic nerve damage even over a brief period of several weeks.