Corneal Irregularity After LASIK Induced by Eyelid Disease

Abstract

PURPOSE: To describe an unusual case of lower eyelid cystic lesions inducing irregular astigmatism and a decrease in visual acuity following laser in situ keratomileusis (LASIK) surgery. METHODS: A 32-year-old woman presented with decreased vision and foreign body sensation. She underwent uncomplicated LASIK, followed by an enhancement procedure 2 months prior to her visit. Uncorrected distance visual acuity was 20/80 with a refraction of +1.25 −0.75 × 135°, correcting her visual acuity to 20/30. RESULTS: Examination showed inferior punctate keratitis. Thinning and flattening were noted on topography. Epithelial mapping showed inferior epithelial thinning and nasal thickening. Further evaluation identified multiple asymptomatic cystic lesions on the lower eyelids. The patient was diagnosed as having mechanical pressure-induced corneal flattening and thinning. A bandage contact lens was used, the cornea returned to its regular shape, and there was no recurrence after lesion excision. CONCLUSIONS: LASIK may have weakened the biomechanical properties of the cornea and predisposed the eye to pressure-induced corneal irregularities. A bandage contact lens proved to be protective. Screening for eyelid disease is advised before and after LASIK. [ Journal of Refractive Surgery Case Reports. 2022;2(1):e6–e9.]