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Vitreoretinal surgery for bilateral macular holes after laser-assisted in situ keratomileusis for the correction of myopia: a case report

García-Fernández Miriam, Castro-Navarro Joaquín, Bajo-Fuente Antonio

Journal of Medical Case Reports · 2012

doi:10.1186/1752-1947-6-381 (opens in a new tab)

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Abstract

<p>Abstract</p> <p>Introduction</p> <p>Laser-assisted <it>in situ</it> keratomileusis surgery may induce postoperative changes in the vitreomacular interface due to the mechanical stretch of the vitreous produced by the suction ring and the shock waves generated by the excimer laser and, subsequently, may provoke macular hole formation.</p> <p>Case presentation</p> <p>A 53-year-old Spanish woman who had undergone a laser-assisted <it>in situ</it> keratomileusis for the correction of myopia in her right and left eye (10 years ago) was referred to our department with a complaint of decreased visual acuity in both eyes. A fundoscopy and optical coherence tomography examination revealed a bilateral full-thickness macular hole. A 23-gauge sutureless pars plana vitrectomy was performed in both eyes, and 1 month after surgery her visual acuity improved and the hole closed.</p> <p>Conclusion</p> <p>The development of a bilateral full-thickness macular hole after laser-assisted <it>in situ</it> keratomileusis has been reported once. This case study enhances our understanding of the vitreoretinal pathology induced by laser-assisted <it>in situ</it> keratomileusis, showing the importance of a rigorous follow-up, because complications may occur even a decade later. In this case study we must also consider the contribution of the underlying myopia to the development of the bilateral macular holes.</p>

Abstract licence: CC BY-NC-ND

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