Optic neuropathy associated with laser in situ keratomileusis

Purpose: To report 4 cases of optic neuropathy following laser in situ keratomileusis (LASIK). Setting: Tertiary care ophthalmic practices. Methods: In this retrospective observational case series, 4 patients who developed acute visual loss following LASIK are reported. All had clinical evidence of optic neuropathy. Two had optic disc edema and 2 had normal appearing optic discs initially. None of the patients experienced significant visual recovery, and all developed optic atrophy in the affected eye. Results: All patients had evaluations for alternative etiologies of their optic neuropathy, with negative results. All patients were therefore presumed to have experienced an ischemic optic neuropathy following LASIK. Conclusions: Patients who have LASIK may experience an acute anterior or retrobulbar optic neuropathy. The etiology is unknown but may be related to the marked increase in intraocular pressure that occurs during a portion of the procedure. (C) 2000 ASCRS and ESCRS.