Retinal Detachment in Myopic Eyes After Laser

Abstract

PURPOSE: To analyze the incidence and characteristics of retinal detachment in myopic patients treated by laser-assisted in situ keratomileusis.

METHODS: We retrospectively studied the retinal detachments observed in 1,554 consecutive eyes (878 patients) undergoing laser-assisted in situ keratomileusis for the correction of myopia (follow-up, 30.34 6 10.2 months; range, 16 to 54). Mean patient age was 33.09 68.6 years (range, 20 to 60). Before treatment with laser-assisted in situ keratomileusis, all patients had a comprehensive examination, and detected lesions predisposing to retinal detachment were treated before performing the laser-assisted in situ keratomileusis procedure.

RESULTS: Retinal detachment occurred in four (0.25%) of 1,554 eyes of four (0.45%) of 878 patients. All four patients who developed retinal detachment in one eye were women. Degree of preoperative myopia was 213.52 6 3.38 diopters (range, 28.00 to 227.50). The time interval between refractive surgery and retinal detachment was 11.25 6 8.53 months (range, 2 to 19 months). In all cases retinal detachment was spontaneous.

In all eyes the retina was reattached successfully at the first retinal detachment surgery. Mean best-corrected visual acuity after laser-assisted in situ keratomileusis and before retinal detachment development was 20/43 (range, 20/50 to 20/30). After retinal detachment repair, best-corrected visual acuity was 20/45 (range, 20/50 to 20/32). Differences between best-corrected visual acuity before and after reattachment were not statistically significant (P 5 .21, paired Student t test). A myopic shift was induced in three eyes that had retinal detachment repaired by scleral buckling, from 20.58 6 0.72 diopter (range, 10.25 to 21.00) before retinal detachment and 22.25 6 1.14 diopters (range, 21.00 to 23.25) after retinal detachment surgery (P 5 .03, paired Student test).

CONCLUSIONS: Laser-assisted in situ keratomileusis for correction of myopia is followed by a low incidence of retinal detachment. Conventional scleral buckling surgery was successful in most cases and did not cause significant changes in the final best-corrected visual acuity. A significant increase in the myopic spherical equivalent was observed after scleral buckling in these patients. (Am J Ophthalmol 1999;128:588–594. © 1999 by Elsevier Science Inc. All rights reserved.)