Keratocyte activation and inflammation in diffuse lamellar keratitis after formation of an epithelial defect

A 27-year-old man presented with corneal ectasia in his left eye 4 years after myopic laser in situ keratomileusis (LASIK) and was treated with riboflavin-ultraviolet-A (crosslinking). During the first post-treatment days, diffuse lamellar keratitis (DLK) (stage III) developed. The microbiology culture was negative. After intensive treatment with topical corticosteroids, the DLK resolved during the following 2 weeks. Crosslinking for post-LASIK corneal ectasia may induce DLK. Early diagnosis and appropriate treatment with intensive topical corticosteroids is essential to successfully manage this post-crosslinking complication.

Section: Discussionmentioning

confidence: 98%

Diffuse lamellar keratitis after corneal crosslinking in a patient with post-laser in situ keratomileusis corneal ectasia

Kymionis

Bouzoukis

Diakonis

et al. 2007

“…[4][5][6][7][8] Triggering the inflammatory cascade through various means may cause leukocyte migration into the corneal stroma, where they accumulate into a previously created potential space, the LASIK flap interface. 9 To our knowledge, this is the first reported incidence of DLK following SLT and, significantly, it occurred bilaterally despite the use of prednisolone acetate 1% prophylaxis against inflammatory reaction in the second eye following SLT.…”

Section: Discussionmentioning

confidence: 99%

“…Described triggers in the late postoperative period include conductive keratoplasty, epithelial erosion, epithelial abrasion, and uveitis. [4][5][6][7][8] We describe what we believe is the first reported incidence of bilateral DLK following consecutive SLT treatments. …”

mentioning

confidence: 99%

Bilateral diffuse lamellar keratitis following consecutive selective laser trabeculoplasty in LASIK patient

Holz¹,

Pirouzian²

2010

A 48-year-old man with a history of myopic laser in situ keratomileusis (LASIK) had selective laser trabeculoplasty (SLT) for the treatment of glaucoma in the right eye. He subsequently developed grade 2 diffuse lamellar keratitis (DLK). He then elected to have SLT in the left eye and developed grade 1 DLK. To our knowledge, this is the first report of bilateral consecutive late postoperative DLK following SLT after LASIK.

“…Even minor intraoperative complications such as epithelial defects have been shown to have the potential to decrease the final outcome because of their association with diffuse lamellar keratitis, flap slippage, and keratocyte apoptosis in the underlying stroma. 5,[7][8][9][10][11][12][13][14] Risk factors for epithelial defects include epithelial basement membrane dystrophy, age, and corneal thickness. 5,15,16 Tangential forces during the microkeratome pass are thought to be the main reason for epithelial defects.…”

Section: Discussionmentioning

confidence: 99%

Laser in situ keratomileusis flap thickness using the Hansatome microkeratome with zero compression heads

Taneri¹

2006

There was a remarkable difference in the flap thickness of microkeratomes of the same make and model. This emphasizes the need to measure intraoperative flap thickness and to evaluate every microkeratome separately. Factors affecting flap thickness seem to be more device dependent than patient related; obtaining flap thickness in the first eye did not enable predictions of the flap thickness in the fellow eye.