The Effect of Diffuse Lamellar Keratitis on Visual Acuity and Contrast Sensitivity following LASIK

Abstract

PurposeTo evaluate visual outcome and the changes of contrast sensitivity (CS) after diffuse lamellar keratitis (DLK).MethodsUsing retrospective chart review, 48 eyes of 25 patients who underwent laser in situ keratomileusis (LASIK) with Visx S4 (VISX Inc., Santa Clara, CA) and M2 (Moria, France) and who were followed for at least six months were included. They were divided into two groups: DLK and non-DLK, by diagnosis of DLK or its absence after LASIK. Postoperative logMAR visual acuities and logCS measured using the VCTS® 6500 (Vistech Consultants, Inc., Dayton, OH) were compared with preoperative values in the DLK and non-DLK groups at three and six months after LASIK.ResultsThere was no difference in logMAR visual acuity between the DLK and non-DLK groups until the sixth postoperative month. However, CS was significantly decreased at 12 and 18 cycle/degree compared with preoperative values (p=0.043 and p=0.045, respectively) in the DLK group, whereas CS was significantly increased at 12 cycle/degree in the non-DLK group (p=0.042) at six months.ConclusionsDLK seemed to be strongly associated with a postoperative decrease of CS.

Visual outcomes and management after corneal refractive surgery: A review

“… 51 It seems that DLK alters contrast sensitive more than visual acuity. Han et al, 57 observed similar visual acuities in DLK and non-DLK eyes, but contrast sensitivity was significantly reduced in DLK group. Even though interface complications are almost exclusive of LASIK, DLK has also been described after SMILE, but the incidence is much lower.…”

Incidence of diffuse lamellar keratitis after LASIK with 15 KHz, 30 KHz, and 60 KHz femtosecond laser flap creation

“…Fortunately, progression to advanced stages of DLK is rare 7–8. Nevertheless, DLK increases the risk of future LASIK enhancement9 and may result in decreased contrast sensitivity 10…”