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Preclinical cataract masquerading as post-LASIK regression.

Rohit Shetty¹, Nikhil Negalur¹, Mathew Kurian¹

¹Cataract, Refractive and Cornea Services, Narayana Nethralaya, Bengaluru, Karnataka, India.

Oman Journal of Ophthalmology

|November 16, 2016

Summary

Preclinical cataracts can mimic post-LASIK regression, causing blurred vision. Aberrometry can detect early lens changes and higher-order aberrations (HOAs) before cataracts are clinically visible.

Keywords:

Aberrometry post-LASIK regression preclinical cataract

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Area of Science:

Ophthalmology
Refractive Surgery
Ophthalmic Diagnostics

Background:

Laser-Assisted In Situ Keratomileusis (LASIK) is a common refractive surgery procedure.
Post-LASIK regression, characterized by a return of refractive error, can occur after surgery.
Early detection of visual disturbances is crucial for appropriate patient management.

Observation:

A 36-year-old female experienced vision blurring a year after LASIK.
Corneal topography and aberrometry initially showed normal results.
Slit lamp examination revealed no morphological lens abnormalities, yet higher-order aberrations (HOAs) and increased lenticular density were detected.

Findings:

Increased HOAs and lenticular density were observed, suggesting preclinical cataract formation.
A year later, the patient developed clinically detectable lenticular changes and worsening scatter.
Aberrations and lenticular density increases may precede overt cataract development.

Implications:

Preclinical cataracts can be misdiagnosed as post-LASIK regression, potentially leading to unnecessary re-operations.
Aberrometry is a valuable tool for identifying early lens changes and differentiating them from refractive regression.
Early detection of lens-related visual changes can prevent inappropriate interventions and guide timely cataract management.