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Retinal Complications After Refractive Surgery

With the increasing acceptance of refractive surgery as treatment for refractive error, an awareness of potential complications is imperative. Refractive surgeries are categorized as keratorefractive procedures or lensbased procedures. Laser in situ keratomileusis (LASIK) and excimer laser photorefractive keratectomy (PRK) are the most commonly performed keratorefractive procedures. Lens-based refractive procedures include phakic intraocular lens (PIOL) implantation and refractive lens exchange (RLE). Retinal complications, although rare, have been reported following all forms of refractive surgery. Although lens-based refractive surgery shares a risk profile similar to that of other intraocular procedures, the association between keratorefractive surgery and retinal pathology is more vague. As most of these complications are reported in myopic eyes with higher risk of retinal pathology, it remains unknown whether the incidence differs from that in a comparable myopic population without refractive surgery. However, the short time interval between keratorefractive surgery and diagnosis of retinal pathology described in some cases, sometimes bilaterally, continues to prompt further attention. The most commonly reported adverse event involving the posterior segment is rhegmatogenous retinal detachment (RRD) after myopic LASIK. Other retinal pathologies noted after LASIK include choroidal neovascularization (CNV), macular hemorrhage, lacquer crack, and macular hole (MH). Nearly all of these other complications are, in fact, manifestations of myopic maculopathy. Retinal detachment, CNV, macular hemorrhage, MH, and cystoid macular edema