A Case of Acute Central Stromal Melting after LASIK

ABSTRACT

LASIK is an effective and exact procedure to correct myopic refractive error but fatal complication may be happened during making corneal flap using microkeratome. We report a patient who developed acute central stomal melting following LASIK on postoperative day 4. This complication was treated by lifting the flap and scraping the interface of corneal flap & central stroma with a metal blade. After 4 months, overcorrected hyperopic refractive error was retreated with excimer laser ablation and patient recovered successful visual acuity. The pathogenesis of this case is not completely understood. Corneal endothelium and central cornea stroma may be mechanically damaged due to excessive suction ring application during LASIK procedure. Interface epithelial ingrowth may be associated with early postoperative inflammation and infection of corneal flap may produce proteinase which melts corneal flap. If corneal flap melting happens after LASIK procedure, early surgical debridement of melting stroma and proper reattachment of the flap may be needed.