[Steroid glaucoma after laser in situ keratomileusis]

Abstract

Background: A steroid-induced glaucoma may develop after bilateral laser in situ keratomileusis (LASIK) with normal intraocular pressure in applanation tonometry.

Methods: We present the case of a 32-year-old patient who underwent bilateral LASIK for myopia. Postoperatively, a steroid-induced glaucoma developed. After the steroid therapy was stopped applanation tonometry showed normal values. A slight corneal opacity was interpreted as a keratokonjunctivitis sicca because of occupational noxa. One year after LASIK, the patient presented with high intraocular pressure (IOP), maximally excavated optic nerve head and extensive visual fields defect in both eyes.

Conclusion: Elevated IOP after LASIK can lead to fluid accumulation in the interface. In this case applanation tonometry can underestimate the intraocular pressure. Even when steroid therapy is stopped, the elevated pressure can persist. This complication after LASIK is very rare and can cause severe damage if not diagnosed.