Corneal Thinning and Opacity following Selective Laser Trabeculoplasty: A Case Report

Aims: Selective laser trabeculoplasty (SLT) (Lumenis, Santa Clara, CA) was developed in 1999 as a means to lower IOP in patients with glaucoma. It is a relatively safe procedure. We report a rare side effect of corneal opacity and stromal haze with corneal thinning and hyperopic shift following SLT.
Presentation of Case: Case report.
Results: A 50 year-old Asian male who underwent SLT OD developed mild corneal edema and slightly elevated intraocular pressure (IOP) one day after procedure. He was prescribed anti-inflammatory drops. One week afterwards, he developed a small corneal abrasion centrally. He was given topical antibiotics and asked to continue anti-inflammatory drops. On postoperative day 8, his corneal abrasion healed, but he developed stromal corneal haze. Topical steroids were begun. By postoperative week #2, his visual acuity and stromal haze had improved. His corneal thickness decreased from 600 µms to 468 µms. After one year, he had almost complete resolution of his corneal pathology but had residual corneal thinning and flattening.
Discussion: Corneal stromal haze following SLT is a rare side effect. This can result in corneal scarring with corneal thinning and a hyperopic shift due to corneal flattening. Physicians and patients should be aware of this potentially vision threatening side effect.
Conclusion: More studies are needed to identify risk factors for the development of corneal pathology following selective laser trabeculoplasty.