Rainbow glare after laser-assisted in situ keratomileusis: a review of literature

Abstract

Majid Moshirfar,1,2 Jordan D Desautels,3 Tyler S Quist,4 David F Skanchy,5 Mark T Williams,6 Ryan T Wallace7 1Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, 2HDR Research Center, Hoopes Vision, Draper, UT, 3Tufts University School of Medicine, Boston, MA, 4University of Utah School of Medicine, Salt Lake City, UT, 5McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, 6University of California, San Francisco School of Medicine, San Francisco, CA, 7Brigham Young University, Provo, UT, USA Abstract: This article reviews the current literature pertaining to rainbow glare (RG), including incidence rate, clinical presentation, etiology, prognosis, and management. RG is a rare optical complication of femtosecond laser-assisted in situ keratomileusis that results in patients seeing an array of spectral bands surrounding point sources of light under mesopic and scotopic conditions. The mechanism is thought to be a consequence of the formation of a transmissive diffraction grating on the posterior surface of the corneal flap created by the FS laser. RG has a good prognosis and is usually self-limiting. Persistent RG with concomitant residual refractive error may warrant lifting the flap and photoablating the posterior surface of the flap. Patients with persistent RG and no residual refractive error should be considered candidates for phototherapeutic keratectomy on the posterior flap surface. Keywords: rainbow glare, femtosecond, LASIK, keratomileusis, phototherapeutic keratectomy

Keywords

• rainbow glare
• femtosecond
• LASIK
• keratomileusis
• photo therapeutic keratectomy (PTK).