Infraorbital nerve palsy: a complication of laser in situ keratomileusis.

PURPOSE To report infraorbital nerve dysfunction after laser in situ keratomileusis. DESIGN Observational case report. METHODS Neuro-ophthalmologic examination with brain and orbital magnetic resonance imaging (MRI) and orbital computed tomography (CT). RESULTS During laser in situ keratomileusis, two healthy women, aged 42 and 46 years, experienced acute onset of sharp ipsilateral cheek pain. Both cases occurred during manipulation of the eyelid speculum. Postoperatively, ipsilateral numbness and tingling or pain of the upper cheek was reported, and examination showed decreased sensation in the distribution of the infraorbital nerve. In both cases, brain and orbit MRI and orbit CT were normal. Both patients were managed medically. In one patient, mild symptoms persisted 1 year postoperatively, and in the second patient, moderate discomfort persisted 8 months postoperatively. CONCLUSION Infraorbital nerve palsy is a potential complication of laser in situ keratomileusis. Symptoms improve but may persist.