Filamentary keratitis occurring in different flap preparation styles of corneal refractive surgery

Abstract

Objective To compare the incidence, underlying pathophysiology, and clinical features of filamentary keratitis in different flap preparation styles of excimer laser surgery. Methods It was a retrospective case-control study. All 28702 eyes were divided into group A including 23082eyes treated with laser-assisted in situ keratomileusis in Xiamen Eye Center of Xiamen University between July 2004 and July 2010 with 90 m microkeratome flap preparation, group B of 1030 eyes treated with laser-assisted in situ keratomileusis with 100 m femoto-second laser flap preparation and group C of 4590 eyes treated with laser epithelial keratomileusis. The incidences of the postoperative filamentary keratitis were observed and compared. In cases suffered with filamentary keratitis changes in corneal signs by slitlamp evaluation, appropriate artificial tears therapy and therapeutic lens treatment were required. Results The incidences were significantly different (P ＜0.05) between group A, group B and group C with 0.16%, 0 and 1.35% respectively, and all cases suffered with filamentary keratitis had complete healing. No additional complications were reported. Conclusions The incidence of filamentary keratitis after excimer laser corneal refractive surgery is affected by the different flap preparation styles. The removement of filaments and the use of artificial tears and soft contact lenses for therapeutic purposes are safe, effective and practical. Key words: Femoto-second laser ; LASIK ; LASEK ; Filamentary keratitis ;