Treatment of grade IV diffuse lamellar keratitis with oral doxycycline and topical 10% sodium citrate

Jarade, Elias; Slim, Élise; Antoun, Joëlle; Khzam, Rayan Abou

doi:10.1016/j.jcjo.2016.07.004

Cited by 5 publications

(8 citation statements)

References 39 publications

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“…This should be performed as soon as possible, on day 2 or 3, to interrupt the inflammatory response and to prevent corneal melting and permanent scarring [ 15 ]. However, lifting the flap can increase the incidence of striae [ 13 ], and evidence in the literature showed that treatment of severe DLK with topical and oral high-dose steroids produces excellent results without flap lifting and interface irrigation [ 4 , 13 , 14 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is also known that when the cornea is injured, corneal epithelial cells and other local cells immediately release a large number of mediators, including nitric oxide, interleukin 1, and matrix metalloproteinases (MMPs), to recruit inflammatory cells into the local injured cornea [ 4 ], so treating the corneal inflammatory response could prevent corneal melting even in the advanced stage of DLK.…”

Section: Discussionmentioning

confidence: 99%

“…Based on these data, we immediately started intensive topical therapy with dexamethasone eyedrops in addition to prophylactic antibiotic treatment. On day 5, when slit lamp biomicroscopy showed worsening of DLK in both eyes, we started to use oral doxycycline and topical 10% sodium citrate for their anticollagenase activity, as suggested by Jarade et al [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…We report a case of severe DLK following femto-LASIK successfully treated without corneal flap lifting with 1 year of follow-up. To our knowledge, there are only few case reports or series of grade 4 DLK after femto-LASIK [ 4 , 5 ], and no descriptions but one [ 6 ] of the clinical evolution of this syndrome with anterior segment optical coherence tomography (OCT) has been published. We suggest anterior segment OCT as a very effective method to follow the course and the severity of corneal stromal involvement.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis, Clinical Trend, and Treatment of Diffuse Lamellar Keratitis after Femtosecond Laser-Assisted in situ Keratomileusis: A Case Report

Balestrazzi

Balestrazzi²,

Giannico³

et al. 2018

Case Rep Ophthalmol

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We report a severe case of diffuse lamellar keratitis (DLK) following femtosecond laser-assisted in situ keratomileusis (femto-LASIK). A 25-year-old man was submitted to 150 kHz iFS® IntraLase-assisted LASIK in both eyes for compound myopic astigmatism. The day after surgery, clinical examination showed a diffuse whitish granular cell reaction particularly in the right eye. High-dose dexamethasone eyedrops with topical antibiotic and artificial tears were prescribed. Five days after surgery, a central corneal opacity with convergent striae was detected at biomicroscopy. The suspicion of DLK was confirmed. Additional therapy based on hyperosmolar ophthalmological solution, oral doxycycline, and topical 10% sodium citrate was prescribed. Treatment was continued and tapered for over 3 months. Improvement in corneal transparency were obtained 2 weeks after the systemic therapy had been started. Uncorrected visual acuity improved from 20/32 to 20/20 at 1-year follow-up. DLK represents an infrequent complication after femto-LASIK. It should resolve without sequelae if promptly diagnosed and treated, without necessity of corneal flap lifting.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnosis, Clinical Trend, and Treatment of Diffuse Lamellar Keratitis after Femtosecond Laser-Assisted in situ Keratomileusis: A Case Report

Balestrazzi

Balestrazzi²,

Giannico³

et al. 2018

Case Rep Ophthalmol

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“…Kaldı ki tedavisinde zaman kaybetmeden topical ve/veya sistemik kortikosteroidler ile sistemik H2 reseptör blokerlerin yani sistemik antihistaminiklerin de kullanılması esastır. 28 Her ne kadar topikal ve sistemik tedavi çok önemli ise de flepi tekrar kaldırarak (flep lifting) yapılan ara yüzey yıkaması (interface irrigasyon) da özellikle 2 ve 3. evre DLK'de şarttır. Bu mekanik ve temizleyici işlem inflamasyonun ara yüzeyden süpürülüp yıkanması gibi bir temizleyici etkiye sahiptir.…”

Section: Görülme Sıklığı Ve Nedenleriunclassified

Diffuse lamella keratitis: diagnosis and treatment methods

Karaarslan¹

2019

Mersin Üniversitesi Sağlık Bilimleri Dergisi

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ÖzRefraktif cerrahi sonrası gelişen diffüz lameller keratit, çoğunlukla unilateral (tek gözde), görme ekseninden uzak, periferal yerleşimli küçük gri-beyaz korneal noktacıklar şeklinde ortaya çıkan bir komplikasyon tablosudur. Başlangıç evrelerde farkına varılmaz ve uygun tedavi ile önlem alınmazsa, ileride ciddi görme kaybına neden olabilmektedir. Özellikle aktif ve genç nüfusun, gözlük ve lens bağımlılığından kurtulmak için tercih ettiği refraktif cerrahi gün geçtikçe daha yoğun bir şekilde uygulanmaktadır. Bu yazıda; ilerleyici ve geri dönüşümsüz kornea ve görme hasarına neden olabilecek, diffüz lameller keratitin, erken tanısı ve tedavisi ile ileride gelişebilecek kalıcı görme kaybının önlenmesi için güncel yaklaşımların ortaya konulması amaçlanmıştır.Anahtar sözcükler : Refraktif cerrahi, diffüz lameller kerattit, korneanın kalıcı nekrozu Diffuse lamella keratitis: diagnosis and treatment methods AbstractDeveloping after refractive surgery, Diffuse Lamellar Keratitis is a complication that appears as small gray-white corneal spots in the periphery. It is mostly unilateral (one-eye) and distant to the visual axis. If it goes unnoticed at initial stages, and if appropriate treatment is not applied, it may cause severe visual impairment. Refractive surgery is especially preferred by active and young population to be released of glasses and lens dependence, and is becoming widely applied with each passing day. In this paper, the purpose is to determine the early diagnosis and treatment modalities for Diffuse Lamellar Keratitis, and to examine current approaches for the prevention of permanent visual impairment, which may lead to progressive and irreversible corneal and visual damage.

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Severe diffuse lamellar keratitis after femtosecond laser-assisted in situ keratomileusis: Case report

Aulanier

Levy

Denis

et al. 2023

Journal Français d'Ophtalmologie

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Treatment of grade IV diffuse lamellar keratitis with oral doxycycline and topical 10% sodium citrate

Cited by 5 publications

References 39 publications

Diagnosis, Clinical Trend, and Treatment of Diffuse Lamellar Keratitis after Femtosecond Laser-Assisted in situ Keratomileusis: A Case Report

Diagnosis, Clinical Trend, and Treatment of Diffuse Lamellar Keratitis after Femtosecond Laser-Assisted in situ Keratomileusis: A Case Report

Diffuse lamella keratitis: diagnosis and treatment methods

Severe diffuse lamellar keratitis after femtosecond laser-assisted in situ keratomileusis: Case report

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