Vitrectomy after Lasik due to Floaters

One of the complications associated with LASIK surgery are vitreous floaters , more commonly called floaters. The images below were taken with a technology known as “optical coherence tomography” or simply OCT. These images are all of the same eye. The first 2 images are cross sectional images of the macular area of the retina, where clear sharp vision begins to take place. The 3rd image is a direct “head on” view of this same section of this retina. Many years after LASIK surgery was done on this eye, numerous floaters began appearing in the eye in a very short amount of time. This patient referred to what he was seeing as “huge sheets of floaters”. Rather than live with these floaters, he elected to undergo a vitrectomy, which is a surgery done to remove the bulk of the ocular interior (the vitreous) and replacing this gel-like substance with saline solution. One of the complications associated with a vitrectomy is that cataract surgery will need to be done about a year later. This eye underwent cataract surgery one year later. Due to complications of the cataract surgery, an additional surgical procedure needed to be done which included yet another vitrectomy. I saw this patient 2 days after the 2nd vitrectomy and took the 2nd and 3rd OCT images. To better explain, the first OCT image was taken about one year prior to the 2nd vitrectomy but after the 1st vitrectomy. Note that the layers of the retina are distinct and smooth when compared to the 2nd OCT image. After undergoing the 2nd vitrectomy, the intraocular pressure in this eye dropped dangerously low to 4 mm. A normal intraocular pressure is about 16mm. This low eye pressure condition is known as “hypotony” and can lead to permanent vision loss or even to loss of an eye. In the 2nd image, note how jagged and wrinkled this retina appears. The 3rd OCT image is a direct view of this same part of this patient’s retina. Note the wrinkles along the retinal surface. After the 2nd vitrectomy, this patient noted a great deal of visual distortions. We caught this condition in time to allow the proper medical treatment which increased the intraocular pressure to a normal level. This patient is now seeing much clearer with this eye but still is noticing some distortions in the visual field with this eye.

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