Corneal bed perforation by laser ablation during laser in situ keratomileusis

A 34-year-old man was referred to our department with corneal perforation after multiple laser in situ keratomileusis procedures for myopia. Corneal perforation occurred at the time of laser application during the fourth surgery, and the anterior chamber became completely flat. The perforation was sealed shortly thereafter and the corneal edema disappeared in 3 weeks, but there was an 86 microm forward shift of the cornea associated with an 8.0 diopter myopic shift during the subsequent 6 months. No further forward bulging of the cornea was observed. The refraction had stabilized up to 2 years postoperatively, but corneal irregular astigmatism limited the patient's best spectacle-corrected visual acuity.