XXXX after LASIK.

@entity1 @entity308 @entity148 @entity936 @entity158 @entity3856 @entity9
PURPOSE: To illustrate that @entity9 may be the basis for refractory @entity936 after laser-assisted in situ keratomileusis (LASIK). METHODS: The methodology used is that of a retrospective medical record review of a small case series. RESULTS: Three male @entity1 , aged 30 to 48 years, referred in 2012 for @entity936 refractory to treatment within 1 year of LASIK or LASIK enhancement are reported. Each @entity1 gave history of @entity3856 , light sensitivity, and difficulty with visual activities beginning within 2 months of LASIK or LASIK enhancement. Best-corrected visual acuity was 20/15 or 20/20 in each of the six eyes. Tear-centered models and metrics did not explain persistent symptoms, which was consistent with inadequate response to standard @entity936 treatments used before referral and reported here. In vivo confocal microscopy was abnormal at presentation in each case and was followed over time. Treatments undertaken subsequent to referral included autologous serum tears (three cases), PROSE (Prosthetic Replacement of the Ocular Surface Ecosystem) treatment (two cases), and systemic agents for @entity158 , @entity148 , or @entity308 (three cases). By the end of 2013, at a mean of 23 months after LASIK or LASIK enhancement, symptoms improved in all three @entity1 . CONCLUSIONS: @entity1 with persistent @entity936 out of proportion to clinical signs after LASIK have a syndrome that may best be classified as @entity9 . In vivo confocal microscopy can be informative as to the neuropathic basis of this condition. In keeping with current understanding of complex regional @entity158 , early multimodal treatment directed toward reducing peripheral nociceptive signaling is warranted to avoid subsequent centralization and persistence of @entity158 . Distinguishing this syndrome from typical post-LASIK @entity936 remains a challenge.
