Pressure-induced interlamellar stromal keratitis after vitreoretinal surgery

To describe a patient with pressure-induced interlamellar stromal keratitis after complicated vitreoretinal surgery, occurring 7 years after myopic laser in situ keratomileusis.

Case report and review of the literature.

A 45-year-old man presented with increasing pain and blurring of vision in his left eye 3 weeks after vitreoretinal surgery for rhegmatogenous retinal detachment. This was associated with diffuse corneal stromal haze and raised intraocular pressure. An anterior segment optical coherence tomography revealed fluid between the laser in situ keratomileusis flap and the residual stromal bed.

Pressure-induced interlamellar stromal keratitis can occur many years after laser in situ keratomileusis. The clinical presentation mimics that of diffuse lamellar keratitis, but corneal haze may be absent in the early stages. Once diagnosed, the intraocular pressure should be managed aggressively to prevent the development of irreversible glaucomatous optic neuropathy.