Acute Accommodative Insufficiency After LASIK Due to COVID-19 Infection

To report a case of acute and transient accommodative insufficiency after laser in situ keratomileusis (LASIK) due to coronavirus disease 2019 (COVID-19).

Case report and literature review.

A 36-year-old man complained of acute blurred near vision 7 days after uneventful bilateral hyperopic LASIK, concurrent with the onset of COVID-19 infection. Examination revealed new-onset accommodative insufficiency, with binocular cross-cylinder test demonstrating an accommodative lag of +1.00 diopters (D) in both eyes. Pupillary and ocular motility findings were normal. The patient was prescribed low add multifocal contact lenses for temporary use. Six months postoperatively, accommodative lag resolved, accommodative function returned to baseline, and near vision returned to J1 uncorrected.

This report describes acute accommodative insufficiency as a complication of COVID-19, with spontaneous resolution over 6 months. Given the significant impact on refractive surgery outcomes, the authors recommend delaying elective procedures for at least 6 months after COVID-19, especially in patients presenting with unexplained postoperative near vision changes.