We read with interest the recent article by Hori et al.1 The authors are to be commended for reporting a case of corneal perforation induced by laser in situ keratomileusis (LASIK), a condition treated by applying a therapeutic soft contact lens with topical antibiotics, oral carbonic anhydrase inhibitors, and eye patching.
Dr Hori and associates state, "One may question whether surgery should have been immediately performed. However, suturing of the flap to promote wound closure carries a high risk of inducing additional high irregular astigmatism."1(p1423) Although this is basically true, we believe that LASIK-induced corneal perforations can be severe and that sutures may be necessary. In addition, severe cases may be associated with posterior segment damage. Two cases of LASIK-induced corneal perforations treated with suture of the corneal wound have recently been published in another journal.2
J. Fernando Arevalo, Ernesto Ramirez, Enrique Suarez, Julian Morales-Stopello, Javier Tugues, Jorge Rodriguez. Operative Corneal Perforations Caused by Laser In Situ Keratomileusis. Arch Ophthalmol. 2000;118(12):1707–1708. doi: