Bilateral serous macular detachment following laser in situ keratomileusis.

PURPOSE

To report a case of bilateral serous macular detachment following laser in situ keratomileusis (LASIK).

DESIGN

Observational case report.

METHODS

A 33-year-old man presented with sudden decrease of vision in both eyes 4 days following uncomplicated LASIK in both eyes for spherical equivalent of +5.00 diopters sph in the right eye and +7.00 diopters sph in the left eye. Detailed history with ocular and systemic examination, fluorescein angiography, and optical coherence tomography were done. Retinal examination had a documentation of retinal pigment epithelium atrophy in the macular region in both eyes pre-LASIK.

RESULTS

A diagnosis of central serous chorioretinopathy (CSCR) was made in both eyes, with multifocal alterations in the retinal pigment epithelium and a pocket of serous retinal fluid in the macular region confirmed on OCT. Late venous phase of fluorescein angiogram demonstrated multiple hyperfluorescent foci of leakage, more in the right eye with areas of retinal pigment epithelium staining.

CONCLUSIONS

Preexisting macular pathology, such as retinal pigment epithelium atrophy could be a new contraindication to LASIK for hypermetropia with possible development of CSCR, requiring a careful examination of the fundus pre-LASIK.