Proposed mechanism for retinal tears after LASIK: An experimental model☆
Presented, in part, at: Association for Research in Vision and Ophthalmology Annual Meeting, May, 2000, Fort Lauderdale; Doheny Days Annual Meeting, June, 2000, Los Angeles; and Loma Linda University School of Medicine Department of Ophthalmology First Annual Residents and Alumni Research Day, June, 2001, Loma Linda, California.
Received 19 July 2002; accepted 19 May 2003.
Abstract
Objective
To demonstrate axial length changes associated with anterior shift of the lens/iris diaphragm and anterior vitreous base in human cadaver eyes during suction ring application preceding Moria LASIK, and to propose that these changes may be associated with anterior retinal tears.
Design
Human eye study.
Materials
Eight human eye bank eyes ranging in age from 65 to 73 years. Two eyes had a history of intraocular surgery involving cataract extraction and intraocular lens implantation.
Intervention
Measurements of intraocular pressure via internal manometer and Tono-Pen, anterior chamber depth, and axial length before and after application of a Moria LASIK suction ring.
Main outcome measures
Change in anterior chamber depth and axial length after Moria LASIK suction ring application.
Results
Axial length increases (mean change = 1.125 mm, P = 0.02) after application of the suction ring, whereas anterior chamber depth shows no significant difference (mean change = −0.01 mm, P = 0.98), suggesting anterior movement of the vitreous base resulting in traction on the anterior retina.
Conclusion
Axial length increase with anterior displacement of the vitreous base during suction ring placement might predispose susceptible eyes to anterior retinal tears during and after LASIK.
1Doheny Retina Institute of the Doheny Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, California, USA
2Department of Ophthalmology, Loma Linda University Medical Center, Loma Linda, California, USA
3Department of Ophthalmology, University of California—Irvine, Irvine, California, USA
Correspondence to Christina J. Flaxel, MD, Doheny Retina Institute of the Doheny Eye Institute, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Los Angeles, CA 90033, USA.
ABSTRACT