5 Cases of the Delayed Diffuse Lamellar Keratitis after LASIK

Abstract

Objective To Discussion on the reasons, the clinical features, prevention methods, principles and prognosis of the delayed diffuse lamellar Keratitis after LASIK.Methods Five cases (10 eyes) admitted into the hospital 5 weeks after received LASIK in September 2008 due to the delayed diffuse lamellar Keratitis appeared 3 to 7 days after stopping the use of the glucocorticoid eye drops and the duration of the reaction lasted 1 to 9 weeks (averaged 2.6 weeks).By the partial use of hormones, antibiotics and symptomatic treatment of eye-drops, the irritating symptoms were rapidly alleviated, and the delayed diffuse lamellar Keratitis gradually faded.Only one eye did not fully recovered until 9 weeks later, and the restoration of the vision was good.Results The common clinical features of this group were as the follows: 1.Reaction appeared within 1 week after stopping the use of glucocorticoid eye drops after LASIK; 2.Clear corneal irritation; 3.Severity of symptoms associated with the sequence of eye surgery; 4.Corneal irritation occurred prior to the reaction layer; 5.Layer reaction alleviated from the bottom to the top; 6.Sensitive to hormone eye drops; 7.No or minor effect on vision happened during the reaction, three cases (5 eyes) out of 5 remained unchanged (1.2), 2 eyes dropped 1 line, 2 dropped 2 lines and 1 eye showed a drop of 5 lines, with the disappearance of the reaction, the vision reached to a pre-operation level.Conclusions 1.The occurrence of the diffuse lamellar Keratitis is speculated to the use of corneal iamellar knife.Such factors as the selection of brand razor blades, a good job in disinfection and cleaning of the razor blades can reduce or effectively prevent the occurrence of such reactions; 2.Clinical manifestations are mainly corneal irritation with the desert-like layer changes mainly shown in the lower floor; 3.Sensitive to the hormone-typed eye drops; 4.Response during and after the reaction has no significant effect on the sight, and the prognosis is good. Key words: Diffuse lamellar Keratitis; Laser in situ keratomilensis; LASIK; Complications