LASIK surgery

[Cherylsharkey]

I had LASIK surgery in January to correct my vision so I wouldn't need glasses, everything was great as far as seeing distances but became difficult to read without reading glasses, now 6 months after surgery I have discovered a Macular hole, will be having surgery for the hole next week, just wondered if the lasik could have caused this hole/tear

[Macular_1]

Hello Cheryl,

We have not heard from any of our callers on our helpline that they have developed a macular hole after having LASIK surgery.

Of course this doesn't mean that this was to blame.

It is a question that you should ask your eye care professionals.

We have a factsheet about 'macular holes' and if you would like a copy, please either email a request to [e-mail] or telephone our helpline, 0300 30 30 111 (9.00am to 5.00pm Monday to Friday).

Best wishes

Macular Society

[BasiRose]

Found this online....

News & Perspective > Journal of Medical Case Reports

Vitreoretinal Surgery for Bilateral Macular Holes After Laser-assisted in situ Keratomileusis for the Correction of Myopia

A Case Report

Miriam García-Fernández; Joaquín Castro-Navarro; Antonio Bajo-Fuente

DISCLOSURES J Med Case Reports. 2012;6(381)

IN THIS ARTICLE

Discussion

Nowadays, LASIK is one of the most popular alternatives for correction of low and moderate myopia. Serious complications after LASIK are infrequent and vitreoretinal pathologic conditions, if managed promptly and adequately, can result in good vision. [9]

It is well known that myopia is a risk factor for macular hole formation and changes in vitreomacular interface are involved in its pathogenesis.

LASIK surgery may induce postoperative changes in this interface, for instance, the mechanical stretch of the vitreous produced by the suction ring, might subsequently provoke macular hole formation.

Nevertheless, it is not an easy task to determine if these are myopic holes that would have developed regardless of LASIK.[2]

Several cases of unilateral macular hole after LASIK have been described in the past decade.[2,3,4,5]

Ruiz-Moreno et al.[4] described the case of a patient who developed a unilateral macular hole 12 months after bilateral LASIK for correction of a moderate myopia. Prior to vitreoretinal surgery the patient’s BCVA was 20/ 100, and after PPV with internal-limiting membrane peeling the patient’s BCVA improved to 20/50.[4]

Chan and Lawrence[5] reported that three myopic patients developed a macular hole in one eye after bilateral LASIK or photorefractive keratectomy. A vitrectomy closed the macular hole of two cases with a final best-corrected visual acuity of 20/25 in Case 1 and 20/30 in Case 2, whereas the other patient declined further surgery.

Arevalo et al. [3] reported the largest series of patients with FTMH after LASIK. They analyzed 14 eyes of 13 patients with macular hole development a mean of 13 months after refractive surgery. Posterior vitreous detachment was observed in 42.8% of the eyes after LASIK, and it was not present before. The macular hole was unilateral in 12 of 13 patients (although one of those patients had an impending macular hole in the fellow eye). Surgery closed the macular hole on all 14 eyes, and functional recuperation occurred in 13 of 14 eyes (92.8%).

Thus, all these papers showed that vitreoretinal surgery can be useful in restoring vision for most myopic eyes with FTMH after refractive laser surgery. However, only one of the 24 patients described until now with FTMH development after LASIK showed bilateral presentation as happened in our case study.

Our case showed an extremely infrequent situation, as there is only one previous report describing bilateral full-thickness macular appearance after LASIK. It is well known that patients with bilateral high myopia who have FTMH and retinal detachment in one eye are expected to be at increased risk of retinal detachment in the other eye.

We postulate that in the present case study an identical refraction in both eyes (-8 diopters), and thus a similar grade of degeneration of retinal tissue, may have contributed to a similar response to the same amount of damage induced by LASIK. However, the cases previously reported in the literature were probably patients with a different refractive sphere between both eyes, which consequently required a different intensity of the shock waves generated by the excimer laser, and this caused different grades of retinal damage, such as a macular hole in one eye but not in the other eye.

We must also consider the possibility of macular hole formation secondary to myopic changes, without the influence of LASIK.

An important limitation of our case report is that OCT was not performed before LASIK, and we do not know exactly the appearance of the vitreomacular interface and, subsequently, we cannot determine precisely if the posterior hyaloid was detached or not prior to laser refractive surgery.

[richardsden1000]

I also developed a Macular Hole one month after LASIK surgery. I am 100% positive that it is due to the LASIK Surgery.