Purpose: To report a case of corneal hydrops with perforation in a patient with post–laser-assisted in situ keratomileusis (LASIK) ectasia. Patient and Clinical Findings: A 49-year-old man with an ocular history of myopic LASIK in both eyes, complicated by post-LASIK ectasia, presented with acute injection, photophobia, tearing, and decreased vision. Diagnosis, Intervention, and Outcomes: The patient presented with acute corneal hydrops and was found to have leakage of aqueous fluid at the superotemporal LASIK flap edge. Further evaluation identified a focal rupture in Descemet's membrane with fluid tracking along the flap interface to the flap edge. After a period of conservative treatment with topical therapy and corneal glue, the patient had expeditious improvement in vision and resolution of symptoms. Conclusions: We describe a case of acute corneal hydrops and effective corneal perforation in a patient with post-LASIK ectasia. The episode was managed conservatively, and the patient had improvement of symptoms without the need for surgical intervention. This patient's presentation and clinical course suggests that other patients with similar characteristics may be managed conservatively while still achieving a favorable clinical outcome.
Dmitriev et al. (Thu,) studied this question.