Korean J Ophthalmol.  2018 Apr;32(2):95-102. 10.3341/kjo.2017.0111.

Lamina Cribrosa Changes after Laser In Situ Keratomileusis in Myopic Eyes

• Lee S
• Choi DY
• Lim DH
• Chung TY
• Han JC
• Kee C

• KMID: 2408948
• DOI: http://doi.org/10.3341/kjo.2017.0111

Abstract

PURPOSE
To determine deep optic nerve head structure changes after transient intraocular pressure elevation during laser in situ keratomileusis (LASIK) for myopia.
METHODS
Enhanced depth imaging-optical coherence tomography was performed in each myopic eye that underwent LASIK surgery. Enhanced depth imaging-optical coherence tomography images were created at postoperative 1 day, 1 week, 2 weeks, and 1 month. Lamina cribrosa (LC) thickness, LC depth and prelaminar thickness at the superior, middle and inferior portions of the optic nerve head were measured by two investigators.
RESULTS
Forty eyes in 40 patients were included in the present study. During follow-up, there were no significant differences in prelaminar thickness or LC depth. The LC demonstrated increased thickness at postoperative 1 day at all three locations (superior, middle, and inferior) (p < 0.001, p < 0.001, p < 0.001, respectively). However, no significant changes were observed at postoperative 1 week, 2 weeks, and 1 month.
CONCLUSIONS
The LC thickness could increase at 1 day after LASIK surgery. However, the thickness will gradually return to baseline morphology. Temporary intraocular pressure increase during LASIK does not appear to induce irreversible LC thickness changes.

Keyword

Lamina cribrosa; Laser in situ keratomileusis; Optic disk

MeSH Terms

Follow-Up Studies
Humans
Intraocular Pressure
Keratomileusis, Laser In Situ*
Myopia
Optic Disk
Research Personnel

Figure

• 

  Fig. 1 Delineation of the border of the lamina cribrosa (LC). (A) Prelaminar (PL) thickness was defined as the distance between the anterior border of PL tissue and the anterior LC border (green line arrow). LC thickness was defined as the distance between the anterior border and the posterior border of the LC (red line arrow). LC depth was defined as the average distances (two dotted red line arrows) between the peripheral points of the anterior LC margins and the reference line connecting both the Bruch's membrane openings (white line). When the shadow of the vessel trunk restricts observation of the peripheral LC margin in the nasal area, the observed LC margin was used to measure the peripheral point of the LC margin. (B) LC thickness and depth were measured at the presumed vertical center of three areas (superior, center, and inferior).

• 

  Fig. 2 Lamina cribrosa thickness (µm) changes. Lamina cribrosa thickness at postoperative day 1 was significantly increased compared to that at baseline. However, this value was not significantly different compared with other time points. (A) Superior, (B) middle, and (C) inferior.

• 

  Fig. 3 A representative case. Enhanced depth imaging-optical coherence tomography images of the optic nerve head before and after laser in situ keratomileusis surgery of a 24-year-old female with −4.5 diopters of spherical equivalent. When the images were compared before and after surgery, lamina cribrosa (LC) thickness slightly increased (A) from 125 µm (B) to 173 µm at postoperative 1 day and returned to baseline LC thickness at postoperative (C) 1 week and (D) 1 month. Other parameters such as LC depth or prelaminar (PL) thickness were consistent, based on the results.

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