Pressure Induced Stromal Keratopathy After Phacoemulsification: Case Report
DOI:
https://doi.org/10.48560/rspo.25654Keywords:
Cataract Extraction, Intraocular Pressure, Keratomileusis, Laser In Situ, Phacoemulsification/adverse effectsAbstract
Introduction: To report a case of pressure induced stromal keratopathy (PISK) after phacoemulsification and intraocular lens (IOL) implantation in a patient with ectasia after laser in situ keratomileusis (LASIK) previously treated with femtosecond-assisted intracorneal ring segment (ICRS).
Case Report: A 53-year-old man with post-LASIK ectasia in his right (OD), underwent phacoemulsification and intraocular lens implantation two months after ICRS implantation in OD. On the first operative day, the patient complained of decreased visual acuity. His best corrected visual acuity (BCVA) was 20/80, intraocular pressure was 55mmHg and biomicroscopy revealed diffuse interface haze and corneal edema. Anterior segment optical coherence tomography (AS-OCT) showed interface fluid accumulation. Steroid drops were discontinued and anti-hypertensive drops were added. One week after surgery, his BCVA was 20/40, the cornea was totally clear, and AS-OCT showed complete fluid reabsorption.
Conclusion: Although PISK usually develops early after LASIK, it can also occur different setting associated with high IOP. This report raises concerns regarding postoperative intraocular hypertension prophylaxis in eyes with previous corneal interface creation, in particular the use of corticosteroids, which are known to trigger PISK development.
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