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Elevated intraocular pressure-induced interlamellar stromal keratitis
Michael W Belin1, Sadeer B Hannush, Chi-Wang Yau
1Department of Ophthalmology, Albany Medical College, Albany, New York 12159-9222, USA.
Ophthalmology
|October 3, 2002
Summary
Elevated intraocular pressure can cause a rare post-LASIK complication called PISK, which mimics DLK but doesn't respond to steroids. Lowering eye pressure effectively treats this condition.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Laser Vision Correction
Background:
- Laser in situ keratomileusis (LASIK) is a common refractive surgery.
- Diffuse lamellar keratitis (DLK) is a known postoperative complication of LASIK.
- Atypical presentations of post-LASIK complications require careful characterization.
Observation:
- A series of four cases presented with interface keratitis after LASIK.
- These cases mimicked DLK but occurred later postoperatively.
- Significant intraocular pressure (IOP) elevation was noted in all patients.
Findings:
- The keratitis, termed PISK (Intraocular Pressure Induced Interlamellar Stromal Keratitis), was unresponsive to topical steroids.
- Visual degradation and slit-lamp findings were similar to DLK.
- Dramatic improvement was observed upon lowering IOP and reducing steroid use.
Implications:
- PISK is a distinct post-LASIK entity potentially exacerbated by steroid treatment.
- Early recognition and IOP management are crucial for treating PISK.
- Understanding PISK differentiates it from DLK, guiding appropriate therapeutic strategies.