Endothelial Decompensation Following Epithelial LASIK With Loss of Epithelial Flap

Journal of Refractive Surgery Vol. 25 No. 1 January 2009
Sameer Kaushal, MD; Gaurav Prakash, MD; Namrata Sharma, MD; Jeewan S. Titiyal, MD

PURPOSE
To report a case that showed endothelial decompensation after epithelial LASIK (epi-LASIK).

METHODS
A 23-year-old woman underwent epi-LASIK surgery to correct refractive error of –4.00 –3.00 x 165° in the right eye and –2.50 –2.00 x 15° in the left eye. Preoperatively, the specular count was 2896 cells/mm2 in the right eye and 3046 cells/mm2 in the left eye. Central corneal thickness (CCT) was 490 µm and 493 µm in the right and left eyes, respectively.

RESULTS
Examination on the first postoperative day revealed diffuse corneal edema with radiating Descemet’s folds in the right eye with best spectacle-corrected visual acuity of 20/80. Central corneal thickness was 493 µm and 373 µm in the right and left eyes, respectively, 1 week after surgery. Corneal edema resolved over a period of 3 weeks with healing of the epithelial defect. Endothelial cell count 3 weeks after surgery was 1310 cells/mm2 in the right eye.

CONCLUSIONS
Epi-LASIK can cause significant endothelial cell loss with development of corneal edema. [J Refract Surg. 2009;25:74-76.]

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