Late interface hemorrhage after LASIK

Introduction: In this report, a late-onset flap interface hemorrhage that occurred 14 years after laser-assisted in situ keratomileusis (LASIK) surgery is described. To the authors' knowledge, there are no such cases reported in the literature that occurred over 10 year from surgery, and there is no consensus for the management of such patients. Patient and Clinical Findings: A 59-year-old man with a history of LASIK surgery who presented with acute, painless, decreased vision in his left eye was examined with slitlamp and anterior segment optical coherence tomography (AS-OCT). Slitlamp examination revealed an interface hemorrhage in the left eye emanating from a micropannus in the superior cornea. AS-OCT demonstrated hyperreflectivity in the flap interface. Diagnosis, Intervention, and Outcomes: A late-onset LASIK interface hemorrhage was diagnosed in the patient. Conservative treatment with low-dose corticosteroid eyedrops led to the resolution of the hemorrhage, return of corneal clarity, and improvement in visual acuity by 2 months. Conclusions: Late-onset interface hemorrhage is a rare complication that may occur many years after LASIK surgery. Pannus formation due to prolonged contact lens use before LASIK surgery is a common risk factor. Conservative management without disruption of the flap interface can be an effective treatment option.