[Atypical presentation of ocular hypertension following myopic LASIK]

We present a masquerade syndrome recently described following uneventful laser in situ keratomileusis (LASIK). If misdiagnosed or left unattended, this condition can lead to severe visual loss.

Findings concerning ten patients who underwent uneventful myopic LASIK, but who presented with a granular haze in the interface in the early postoperative period, are described. Initially, some of the patients were treated for diffuse lamellar keratitis with an intensive course of topical steroids, but, rather than improving, the haziness of the interface worsened or remained the same, and was even accompanied by the development of epithelial edema.

Tonometry led to the diagnosis of ocular hypertension induced by the steroid therapy. The clinical picture resolved completely with topical hypotensive treatment and with the cessation of steroid treatment.

In the early postoperative period following LASIK an atypical presentation of ocular hypertension can occasionally be observed. A high index of suspicion of this diagnosis must be maintained due to the inaccuracy of tonometry after LASIK and the similarity of this clinical picture with diffuse lamellar keratitis. These cases emphasize the importance of taking into account underestimation of the intraocular pressure after myopic LASIK.