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Journal of Ophthalmology
Volume 2009 (2009), Article ID 363482, 3 pages
http://dx.doi.org/10.1155/2009/363482
Case Report

Acute Keratoconus-Like Hydrops after Laser In Situ Keratomileusis

Department of Ophthalmology, University of Bonn, Ernst-Abbe Street 2, 53127 Bonn, Germany

Received 2 September 2009; Accepted 14 December 2009

Academic Editor: Susanne Binder

Copyright © 2009 Carsten H. Meyer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. To demonstrate keratoconus-like hydrops after laser in situ keratomileusis (LASIK) by optical coherence tomography (OCT). Patient and Methods. A 21-year-old man received uneventful bilateral LASIK. On slit lamp examination or corneal topography there were no signs of fruste keratoconus. The preoperative corneal thickness was 587- 𝜇 m OD and the calculated ablation for two treatments was 114- 𝜇 m. Uneventful LASIK with an optical zone of 7 mm and an ablation of 89- 𝜇 m OD, and an ablation of 73- 𝜇 m OS was performed. Three years postoperatively, he complained about progressive myopia and impaired vision OD. His VA was hand motion OD and 20/20 OS. Results. OCT and light microscopy revealed an anterior corneal steepening and acute keratoconus-like excessive edematous swelling. Conclusion. The cornea is mechanically weakened after LASIK by the lamellar cut and tissue subtraction. Although the advocated minimal residual stromal bed thickness is 250- 𝜇 m, it may not be adequate to prevent progressive keratoconus-like hydrops in the selected cases.