Sub-Internal Limiting Membrane Hemorrhage Following Femtosecond Laser In Situ Keratomileusis: A Rare Postoperative Complication

Abstract

Purpose: To report a rare case of sub-internal limiting membrane (sub-ILM) hemorrhage following femtosecond laser in situ keratomileusis, successfully managed conservatively. Methods: A single postoperative case was reviewed. Results: A 32-year-old woman presented with unilateral vision loss 1 month after femtosecond laser in situ keratomileusis. Clinical examination revealed a sub-ILM hemorrhage involving the macula, with an initial best-corrected visual acuity (BCVA) of 6/24. The patient underwent conservative management with serial follow-up examinations. Over the following months, the hemorrhage demonstrated progressive spontaneous resolution. At 4 months, the patient had a normal fundoscopic examination, and the BCVA improved to 6/6 without surgical intervention. Conclusions: Sub-ILM hemorrhage may occur as a rare posterior segment complication after laser in situ keratomileusis, even in otherwise healthy patients without known risk factors. Prompt diagnosis and close monitoring are crucial, and surgical intervention should be reserved for cases that fail to resolve spontaneously. To the best of our knowledge, this is the first documented case of sub-ILM hemorrhage following femtosecond laser in situ keratomileusis. Further research is warranted to understand the effects of femtosecond laser in situ keratomileusis on intraocular pressure dynamics and retinal vasculature.