Free LASIK Complication Management Questions and Answers — Questions and Answers

Question 1: What is the most common complication following LASIK surgery?

Cataracts
Glaucoma
Dry eye syndrome (Correct answer)
Macular degeneration

Correct answer: Dry eye syndrome

Dry eye syndrome is the most common complication following LASIK surgery. The creation of the corneal flap can temporarily disrupt corneal nerves responsible for tear production and sensation, leading to reduced tear film stability and increased dryness. While usually temporary, it can cause discomfort and blurry vision, requiring management with artificial tears.

Question 2: What complication can occur if the corneal flap is not properly repositioned?

Retinal detachment
Flap striae (Correct answer)
Cataract formation
Iris damage

Correct answer: Flap striae

Flap striae are microscopic folds or wrinkles in the corneal flap that occur if it is not perfectly smoothed and aligned after repositioning. These striae can cause visual distortion, glare, and reduced visual acuity. Proper intraoperative technique and careful repositioning are crucial to prevent them, ensuring a smooth optical surface.

Question 3: Which sign indicates the presence of diffuse lamellar keratitis (DLK)?

Flap edema
Epithelial ingrowth
Stromal haze
Sterile interface inflammation (Correct answer)

Correct answer: Sterile interface inflammation

Diffuse lamellar keratitis (DLK), also known as 'sands of the Sahara,' is a sterile inflammatory reaction that occurs in the interface between the corneal flap and the stromal bed. It is characterized by a diffuse haze or granular appearance in the interface, caused by an accumulation of inflammatory cells. It is not an infection but an inflammatory response.

Question 4: How is epithelial ingrowth best managed postoperatively?

Administer topical steroids only
Lift flap and irrigate interface (Correct answer)
Monitor without intervention
Photocoagulation

Correct answer: Lift flap and irrigate interface

Epithelial ingrowth occurs when epithelial cells from the corneal surface grow under the repositioned flap. If significant or visually compromising, the most effective management is to lift the flap and mechanically remove the epithelial cells from the interface. This is followed by thorough irrigation to prevent further growth and potential flap melting or irregular astigmatism.

Question 5: What is the initial treatment for DLK?

Topical antibiotics
Corticosteroids (Correct answer)
NSAIDs
Hypertonic saline

Correct answer: Corticosteroids

Diffuse lamellar keratitis (DLK) is a sterile inflammatory condition, not an infection. Therefore, the initial and primary treatment involves topical corticosteroids to suppress the inflammatory response. Early and aggressive treatment with steroids can often resolve DLK and prevent progression to more severe stages that could impact vision.

Question 6: What complication is most associated with improper patient fixation during the procedure?

Flap tear
Corneal melt
Decentered ablation (Correct answer)
Endophthalmitis

Correct answer: Decentered ablation

Improper patient fixation or eye movement during the laser ablation phase can lead to the laser beam treating an area of the cornea that is not perfectly centered. This results in a decentered ablation, where the optical zone is not aligned with the visual axis. Decentered ablations can cause significant visual symptoms like glare, halos, and reduced visual quality.

Question 7: How can nighttime visual disturbances post-LASIK be minimized?

Prescribe tinted lenses
Increase flap thickness
Use large optical zones (Correct answer)
Avoid monovision corrections

Correct answer: Use large optical zones

Nighttime visual disturbances like glare and halos are often related to the size of the treated optical zone. If the pupil dilates larger than the treated zone in low light, light rays passing through the untreated peripheral cornea can cause aberrations. Using larger optical zones during LASIK ensures that the entire pupil area is corrected, minimizing these effects.

Question 8: What is the potential outcome of excessive stromal ablation?

Hyperopia
Myopia regression
Corneal ectasia (Correct answer)
Endothelial failure

Correct answer: Corneal ectasia

Corneal ectasia is a severe complication where the cornea progressively thins and bulges forward, leading to irregular astigmatism and vision loss. Excessive stromal ablation, especially in patients with pre-existing corneal weakness or thin corneas, can compromise the structural integrity of the cornea. This significantly increases the risk of developing ectasia.

Question 9: Which tool is most effective for detecting subtle postoperative corneal irregularities?

Slit-lamp exam
Corneal topography (Correct answer)
OCT of retina
Pachymetry only

Correct answer: Corneal topography

Corneal topography is a diagnostic imaging technique that creates a detailed, color-coded map of the corneal surface curvature. It is highly effective for detecting subtle irregularities, such as decentered ablations, irregular astigmatism, or early signs of ectasia, which might not be apparent with a standard slit-lamp exam. It provides crucial information for post-LASIK assessment and management.

Free LASIK Complication Management Questions and Answers

What is the most common complication following LASIK surgery?