In my opinion anisocoria after LASIK is due to cuttining corneal nerves, which causes pupilary abnormaties due to reflex, as in case of keratitis following myosis.
I have no doubt, I absolutely agree with Marianne Shahsuvaryan, changes in pupil size and shape are related with the fact that some corneal nerves are cut with ablation.
is there any publication supporting this connection between severing corneal nerves and impact on pupilary reflex abnormalities?
In my opinion the cause could be sudden sustained rise in intra-ocular pressure during the procedure leading to ischemic damage. I have seen one case report and a patient with similar problem
The rise in intra-ocular pressure can cause the iris sphincter muscle atrophy, which can be the cause of the dilated pupil. We can see the same problem for the patients who had an intra-oculaire pressure rise after cataract surgery.
I agree with Murat, this is a very plausible explanation and reflects a direct reaction and damage on the site of efektor tissue ,instead of the most complicated reflex mechanism.
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