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Review
. 2016 Nov 9:10:2245-2249.
doi: 10.2147/OPTH.S117971. eCollection 2016.

Rainbow glare after laser-assisted in situ keratomileusis: a review of literature

Majid Moshirfar  1 , Jordan D Desautels  2 , Tyler S Quist  3 , David F Skanchy  4 , Mark T Williams  5 , Ryan T Wallace  6
Affiliations
Review

Rainbow glare after laser-assisted in situ keratomileusis: a review of literature

Majid Moshirfar et al. Clin Ophthalmol. .

Abstract

This article reviews the current literature pertaining to rainbow glare (RG), including incidence rate, clinical presentation, etiology, prognosis, and management. RG is a rare optical complication of femtosecond laser-assisted in situ keratomileusis that results in patients seeing an array of spectral bands surrounding point sources of light under mesopic and scotopic conditions. The mechanism is thought to be a consequence of the formation of a transmissive diffraction grating on the posterior surface of the corneal flap created by the FS laser. RG has a good prognosis and is usually self-limiting. Persistent RG with concomitant residual refractive error may warrant lifting the flap and photoablating the posterior surface of the flap. Patients with persistent RG and no residual refractive error should be considered candidates for phototherapeutic keratectomy on the posterior flap surface.

Keywords: LASIK; femtosecond; keratomileusis; phototherapeutic keratectomy; rainbow glare.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Schematic of rainbow glare. Notes: The centers of slits created by laser spots on the cornea during flap creation are separated by a distance, A, and diffract light of wavelength, λ, at an emergence angle, θm, for a given mode of diffraction (m=0,1, 2, …). The distance between the centers of consecutive slits is related to the diffraction angle by the following diffraction grating equation: A = mλ/sinθm. The fundamental mode of diffraction (m1) represents the brightest set of bands and is therefore the most clinically significant.
Figure 2
Figure 2
Mathematical method for calculating the theoretical slit spacing to be compared to the programmed spot/line spacing on the femtolaser laser outlined by Krueger et al. Notes: A point of light source is pushed through a piece of white paper which is held at arms’ length. The patient can draw the spectrum they see on the piece of paper and the corresponding angle, θm, can be calculated. Knowing the angle, it is easy to calculate the theoretical spot spacing using the diffraction grating equation.
See this image and copyright information in PMC

References

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    1. Krueger RR, Rocha KM, Dupps WJ., Jr . Natural History and Incidence of Rainbow Glare and Light Scattering in Femtosecond LASIK. San Diego, CA: American Society of Cataract and Refractive Surgery; 2015. Paper 16815.
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