Incidence of posterior vitreous detachment after laser in situ keratomileusis

Background Vitreoretinal complications are rare in laser in situ keratomileusis (LASIK). Increase in intraocular pressure caused by intraoperative suction with subsequent deforming of the ocular globe and excimer laser shock during the ablation have been discussed as possible causes. The purpose of this study was to determine the effect of LASIK on the vitreous body. Patients and methods In a prospective study we performed ocular ultrasonography (B scan) immediately before and 1 week after LASIK procedure in 103 myopic or myopic–astigmatic eyes (53 patients, mean age 36.3 years, 32 women, 21 men). In particular, the prevalence, localization, and extent of posterior vitreous detachment (PVD) were determined. Results The mean spherical equivalent was −4.85 D (range −1.25 to −8.38) and the mean anteroposterior ocular globe length was 25.13 mm (range 23.31–27.65). Ninety-five eyes (92.2%) had no PVD preoperatively. Nine eyes out of this group (seven patients, 9.5%) developed incomplete PVD as assessed 1 week postoperatively. Eight eyes (7.8%) had a partial PVD preoperatively and in only one eye was an extension of vitreous detachment observed after the surgery. None of the preoperatively measured parameters could predict the occurrence of PVD by LASIK. Conclusions LASIK may in rare cases lead to new occurrence of PVD or extension of a previously existing partial PVD. Thomas Kohnen is a consultant for scientific advice to Bausch & Lomb, Inc., but neither author has a financial proprietary in any of the instrumentation or devices used in this study. This paper was presented in part at the German Ophthalmic Society (DOG) 2003 annual meeting, Berlin, with the title “LASIK-induced posterior vitreous detachment.”