Clinical analysis of diffuse lamellar keratitis after laser in situ keratomileuses

Abstract

Objective To study the causes,clinical features and prevention measures of diffuse lamel-lar keratitis (DLK)after LASIK. Methods Eleven patients ( 17 eyes) with DLK after LASIK among 199 pa-floats (398 eyes) from March 2007 to December 2007 were selected as observation group,and after the strict checks on operating room environment,pressure sterilizer,surgical instrument disinfection,preoperative con-junctival sac clean and corneal epithelium protection,5 patients (7 eyes) with DLK after LASIK among 148 patients (296 eyes) from December 2007 to May 2008 were selected as control group. Each stage's complex,clinical features and treatment process of DLK were analyzed. Results The incidence rate of DLK in obser-vation group was 4.27%,among which,stage Ⅰ was 3.01%,stage Ⅱ was 0.5% and stage Ⅳ (3 eyes) was 0.75%. The incidence rate of DLK in control group was 2.36%,among which,stage Ⅰ was 1.68% and stage Ⅱ was 0.67%. DLK of stage Ⅰ and stage Ⅱ happened 1～3 days after LASIK,it absorbed entirely after 7～10 days'treatment, and vision rocovered to normal. DLK of stage Ⅳ happened 3～7 days after LASIK, relatively white dense opacity under the lamellar of central cornea and flap melt could be seen through slit lamp. High hyperme-tropia was left after healing. Hypermetropia decreased partly after 3～6 months, and vision recovered to 0.6～1.0. Conclusion The occurrence of DLK after LASIK is related with multifactors. DLK can be prevented by the strict checks on each link of the operation and cured better if it is treated in time. Key words: Laser in situ keratomileuses ; Lamellar keratitis ; Prevention ;