1
|
Sharwood PL, Rogers CM. LASIK flap interface deposition in limbal vernal keratoconjunctivitis. Clin Exp Optom 2021; 91:183-6. [DOI: 10.1111/j.1444-0938.2007.00178.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
2
|
Leccisotti A, Fields SV. Diffuse lamellar keratitis after LASIK with low-energy femtosecond laser. J Cataract Refract Surg 2021; 47:233-237. [PMID: 32925649 DOI: 10.1097/j.jcrs.0000000000000413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 08/16/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the incidence, evolution, and prognosis of diffuse lamellar keratitis (DLK) in a large series of laser in situ keratomileusis (LASIK) with low-energy femtosecond laser. SETTING Private practice, Siena, Italy. DESIGN Retrospective, consecutive, noncomparative case series study. METHODS Single-use instruments, powder-free gloves, and no corneal marking were used. Flap was created by a low-energy femtosecond laser (Ziemer Z2 and Z4). RESULTS A total of 37 315 eyes of 19 602 patients were reviewed. DLK was observed in 236 eyes (0.63%) of 149 patients (0.76%). Grade 1 DLK was observed in 231 eyes of 142 patients, grade 2 in 1 eye: when treated with topical steroids, they had no visual consequences. Three patients had bilateral grade 3 to 4 DLK: one of them, with bilateral grade 3, despite flap lifting and irrigation worsened to stage 4 (central stroma thinning and flattening), partially recovered in 2 years, and underwent repeat femtosecond laser-assisted LASIK for hyperopic shift in 1 eye. In all the 5 eyes that developed grade 4 DLK, corneal thickness decreased until the first month and then partially recovered; mean final tissue loss at 1 to 2 years was 35 µm. Compensatory epithelial thickening was observed. CONCLUSIONS DLK after low-energy femtosecond laser-assisted LASIK is rare; severe DLK (stages 3 and 4) was found in only 6 eyes (0.016%). Flap lifting and irrigation might not prevent progression. Spontaneous reformation of stromal tissue and epithelial thickening improve visual acuity in the long term; residual hyperopic shift can be corrected by repeat femtosecond laser-assisted LASIK.
Collapse
Affiliation(s)
- Antonio Leccisotti
- From the Siena Eye Laser (Leccisotti, Fields), Scuola di Specializzazione in Oftalmologia, Università di Siena (Leccisotti), Siena, Italy, School of Biomedical Sciences, Ulster University (Leccisotti), Coleraine, United Kingdom
| | | |
Collapse
|
3
|
Shah SG, Shah GY. Recurrent late onset diffuse lamellar keratitis. Indian J Ophthalmol 2020; 68:3033-3034. [PMID: 33229694 PMCID: PMC7856958 DOI: 10.4103/ijo.ijo_1551_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Sushmita G Shah
- Life, 204 Ram Krishna Chambers, Linking Road, Khar West, Mumbai, Maharashtra, India
| | - Gaurav Y Shah
- Life, 204 Ram Krishna Chambers, Linking Road, Khar West, Mumbai, Maharashtra, India
| |
Collapse
|
4
|
Ong HS, Chan AS, Yau CW, Mehta JS. Corneal Inlays for Presbyopia Explanted Due to Corneal Haze. J Refract Surg 2018; 34:357-360. [DOI: 10.3928/1081597x-20180308-01] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 02/09/2018] [Indexed: 11/20/2022]
|
5
|
Li M, Yang D, Chen Y, Li M, Han T, Zhou X, Ni K. Late-onset diffuse lamellar keratitis 4 years after femtosecond laser-assisted small incision lenticule extraction: a case report. BMC Ophthalmol 2017; 17:244. [PMID: 29216872 PMCID: PMC5721581 DOI: 10.1186/s12886-017-0641-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 11/30/2017] [Indexed: 12/17/2022] Open
Abstract
Background To report a first case of late-onset diffuse lamellar keratitis (DLK) occurring 4 years after femtosecond laser-assisted small incision lenticule extraction (SMILE). Case presentation A 41-year-old man who underwent SMILE 4 years prior developed DLK in the right eye 1 day after he was struck in the eye by a finger while playing with his son. Slim-lamp microscopy and anterior segment optical coherence tomography (AS-OCT) were used to evaluate the cornea of the right eye. Slit-lamp examination of the right eye revealed epithelial exfoliation and stage 3 DLK with diffuse, dot-like, granular haze in the interface between the cap and stromal bed. After intensive treatment with topical corticosteroids, the DLK resolved and corneal transparency was achieved. Conclusions This case indicates that DLK can occur several years after SMILE. Ocular trauma may be a risk factor for the development of DLK. The prognosis is usually favorable with early diagnosis and treatment with topical corticosteroids.
Collapse
Affiliation(s)
- Meiyan Li
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, China
| | - Dong Yang
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, China
| | - Yingjun Chen
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, China
| | - Meng Li
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, China
| | - Tian Han
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, China
| | - Xingtao Zhou
- Key Lab of Myopia, Ministry of Health, Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, China.
| | - Katherine Ni
- School of Medicine, New York University, New York, USA
| |
Collapse
|
6
|
Morales P, Camos-Carreras A, Spencer F, Torras J, Diaz P. Late-onset diffuse lamellar keratitis 15 years after laser in situ keratomileusis. Can J Ophthalmol 2017; 52:e91-e93. [PMID: 28576227 DOI: 10.1016/j.jcjo.2016.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 11/09/2016] [Indexed: 10/20/2022]
|
7
|
Chey JH, Jo SH, Lee CK. Diffuse Lamellar Keratitis after Trabeculectomy in a Patient with Laser in situKeratomileusis. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.1.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ji Hyoung Chey
- Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea
| | - Seung Hwan Jo
- Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea
| | - Chang Kyu Lee
- Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| |
Collapse
|
8
|
Jarade E, Slim E, Antoun J, Khzam RA. Treatment of grade IV diffuse lamellar keratitis with oral doxycycline and topical 10% sodium citrate. Can J Ophthalmol 2016; 51:e178-e184. [PMID: 27938979 DOI: 10.1016/j.jcjo.2016.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 07/06/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Elias Jarade
- Beirut Eye Specialist Hospital, Beirut, Lebanon; Mediclinic, Dubai Mall, Dubai, United Arab Emirates.
| | - E Slim
- Beirut Eye Specialist Hospital, Beirut, Lebanon; Saint-Joseph University, Faculty of Medicine, Beirut, Lebanon
| | - J Antoun
- Beirut Eye Specialist Hospital, Beirut, Lebanon; Saint-Joseph University, Faculty of Medicine, Beirut, Lebanon
| | | |
Collapse
|
9
|
Corneal Inflammation Following Corneal Photoablative Refractive Surgery With Excimer Laser. Surv Ophthalmol 2013; 58:11-25. [DOI: 10.1016/j.survophthal.2012.04.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 04/16/2012] [Accepted: 04/24/2012] [Indexed: 11/24/2022]
|
10
|
Randleman JB, Shah RD. LASIK interface complications: etiology, management, and outcomes. J Refract Surg 2012; 28:575-86. [PMID: 22869235 DOI: 10.3928/1081597x-20120722-01] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Accepted: 07/16/2012] [Indexed: 01/31/2023]
Abstract
PURPOSE To describe the etiology, diagnosis, clinical course, and management of LASIK interface complications. METHODS Literature review. RESULTS Primary interface complications include infectious keratitis, diffuse lamellar keratitis, central toxic keratopathy, pressure-induced stromal keratopathy (PISK), and epithelial ingrowth. Infectious keratitis is most commonly caused by Methicillin-resistant Staphylococcus aureus (early onset) or atypical Mycobacterium (late onset) postoperatively, and immediate treatment includes flap lift and irrigation, cultures, and initiation of broad-spectrum topical antibiotics, with possible flap amputation for recalcitrant cases. Diffuse lamellar keratitis is a white blood cell infiltrate that appears within the first 5 days postoperatively and is acutely responsive to aggressive topical and oral steroid use in the early stages, but may require flap lift and irrigation to prevent flap necrosis if inflammation worsens. In contrast, PISK is caused by acute steroid response and resolves only with cessation of steroid use and intraocular pressure lowering. Without appropriate therapy PISK can result in severe optic nerve damage. Central toxic keratopathy mimics stage 4 diffuse lamellar keratitis, but occurs early in the postoperative period and is noninflammatory. Observation is the only effective treatment, and flap lift is usually not warranted. Epithelial ingrowth is easily distinguishable from other interface complications and may be self-limited or require flap lift to treat irregular astigmatism and prevent flap melt. CONCLUSIONS Differentiating between interface entities is critical to rapid appropriate diagnosis, treatment, and ultimate visual outcome. Although initial presentations may overlap significantly, the conditions can be readily distinguished with close follow-up, and most complications can resolve without significant visual sequelae when treated appropriately.
Collapse
Affiliation(s)
- J Bradley Randleman
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.
| | | |
Collapse
|
11
|
McMonnies CW, Korb DR, Blackie CA. The role of heat in rubbing and massage-related corneal deformation. Cont Lens Anterior Eye 2012; 35:148-54. [DOI: 10.1016/j.clae.2012.01.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Revised: 01/03/2012] [Accepted: 01/12/2012] [Indexed: 10/14/2022]
|
12
|
Elevated Intraocular Pressure–Induced Interlamellar Stromal Keratitis Occurring 9 Years After Laser In Situ Keratomileusis. Cornea 2012; 31:87-9. [DOI: 10.1097/ico.0b013e31821140fa] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
13
|
Javaloy J, Alió JL, Rodríguez A, González A, Pérez-Santonja JJ. Epidemiological Analysis of an Outbreak of Diffuse Lamellar Keratitis. J Refract Surg 2011; 27:796-803. [DOI: 10.3928/1081597x-20110411-01] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2010] [Accepted: 03/25/2011] [Indexed: 11/20/2022]
|
14
|
Bilateral corneal opacities in a LASIK patient after the use of titanium eye shields. J Cataract Refract Surg 2011; 37:1160-4. [PMID: 21596260 DOI: 10.1016/j.jcrs.2011.03.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Revised: 02/15/2011] [Accepted: 02/15/2011] [Indexed: 11/22/2022]
Abstract
UNLABELLED We report a case of bilateral corneal opacities in a laser in situ keratomileusis (LASIK) patient who subsequently had carbon dioxide (CO(2)) laser skin resurfacing. The presumed etiology of the visually significant corneal opacities was late-onset diffuse lamellar keratitis (DLK), secondary to traumatic corneal abrasions from the use of metal eye shields. The DLK went untreated for 1 month, resulting in permanent interface scarring and a corrected distance visual acuity of 20/30 in the patient's right eye and 20/20 in the left eye. We think patients who have had LASIK and are planning to have CO(2) laser skin resurfacing or any procedure that uses protective metal eye shields should be counseled about the risk for late-onset DLK as a potential complication. This warning is particularly germane now as an increasing number of patients who have had LASIK are entering the decades of life when cosmetic surgery is most likely to be sought. FINANCIAL DISCLOSURE Neither author has a financial or proprietary interest in any material or method mentioned.
Collapse
|
15
|
Campos M, Muccioli C, Malta JB, Gerade RA, LA Salame A, Belfort R. Efficacy and tolerability of a combined gatifloxacin plus prednisolone formulation for topical prophylaxis after LASIK. Clin Ophthalmol 2011; 5:209-14. [PMID: 21386913 PMCID: PMC3046990 DOI: 10.2147/opth.s17059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Indexed: 11/23/2022] Open
Abstract
Purpose: To compare the efficacy and tolerability of a fixed-dose combination of 0.3% gatifloxacin and 1% prednisolone formulation versus the same agents administered separately for prophylaxis in a laser-assisted in situ keratomileusis (LASIK) population. Methods: In a prospective, randomized, double-masked, parallel-group study, 97 patients were evaluated for signs and symptoms of ocular infection or inflammation after bilateral LASIK. Group 1 (50 patients, 100 eyes) received a combined formulation of 0.3% gatifloxacin + 1% prednisolone acetate (Zypred®) plus placebo. Group 2 (47 patients, 94 eyes) received conventional treatment with the same agents from separate vials. The cohorts were similar in age, sex, race, and refractive error. Baseline and postoperative assessments were made on surgery days −2, 1, 3, and 15 and consisted of visual acuity; intraocular pressure; severity of inflammation of eyelids, conjunctiva, and cornea; tearing; ocular discomfort (foreign-body sensation, itching, or photophobia); and ocular pain. The posterior segment was evaluated at the screening and exit visits. Results: No ocular infection or persistent inflammation was detected in either group at any time. All objective and subjective criteria of efficacy were similar regardless of treatment, with no significant differences between the groups. More patients who were dosed with the combined agent complained of mild ocular discomfort on day 3, but this difference had disappeared by day 15. Conclusion: Post-LASIK topical prophylaxis with combined gatifloxacin + prednisolone eye drops (Zypred®) was well tolerated. This formulation appears to be therapeutically equivalent to conventional dosing with gatifloxacin and prednisolone from individual bottles for topical prophylaxis after laser refractive surgery.
Collapse
Affiliation(s)
- Mauro Campos
- Department of Ophthalmology, Hospital São Paulo, Universidade Federal de São Paulo, Brazil
| | | | | | | | | | | |
Collapse
|
16
|
Choe CH, Guss C, Musch DC, Niziol LM, Shtein RM. Incidence of diffuse lamellar keratitis after LASIK with 15 KHz, 30 KHz, and 60 KHz femtosecond laser flap creation. J Cataract Refract Surg 2010; 36:1912-8. [PMID: 21029900 DOI: 10.1016/j.jcrs.2010.09.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 06/01/2010] [Accepted: 06/15/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE To compare the incidence of diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK) with flap creation using the 15 kHz (FS15), 30 kHz (FS30), or 60 kHz (FS60) femtosecond laser. SETTING University-based academic practice, Ann Arbor, Michigan, USA. DESIGN Retrospective comparative case series. METHODS Consecutive myopic LASIK cases performed between January 1, 2005, and June 1, 2007, using the IntraLase FS15, FS30, or FS60 femtosecond laser for flap creation were reviewed. Preoperative clinical characteristics, treatment parameters, and intraoperative and postoperative complications were recorded. Statistical comparisons were made using repeated measures analysis, analysis of variance, chi-square, and Fisher exact tests. RESULTS Five hundred twenty eyes of 274 patients were included in the study. One hundred seventy-six eyes (93 patients) were treated with the FS15 laser, 180 eyes (93 patients) with the FS30 laser, and 164 eyes (89 patients) with the FS60 laser. Seventeen eyes (10%) in the FS15 laser group, 24 eyes (13%) in the FS30 laser group, and 23 eyes (14%) in the FS60 laser group developed DLK. There was no statistically significant difference in the incidence of DLK between the 3 groups (P = .68). CONCLUSION There was no significant difference in the incidence of DLK between the FS15, FS30, and FS60 groups.
Collapse
Affiliation(s)
- Christina H Choe
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | | | | | | | | |
Collapse
|
17
|
Kamiya K, Ikeda T, Aizawa D, Shimizu K. A case of late-onset diffuse lamellar keratitis 12 years after laser in situ keratomileusis. Jpn J Ophthalmol 2010; 54:163-4. [PMID: 20401567 DOI: 10.1007/s10384-009-0774-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Accepted: 09/10/2009] [Indexed: 11/29/2022]
|
18
|
Presumed late diffuse lamellar keratitis progressing to interface fluid syndrome. J Cataract Refract Surg 2008; 34:322-6. [DOI: 10.1016/j.jcrs.2007.09.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2007] [Accepted: 09/02/2007] [Indexed: 11/22/2022]
|
19
|
Spontaneous Bilateral, Recurrent, Late-onset Diffuse Lamellar Keratitis After LASIK in a Patient With Cogan’s Syndrome. J Refract Surg 2008; 24:548-50. [DOI: 10.3928/1081597x-20080501-16] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
20
|
Kymionis GD, Diakonis VF, Bouzoukis DI, Lampropoulou I, Pallikaris AI. Idiopathic Recurrence of Diffuse Lamellar Keratitis After LASIK. J Refract Surg 2007; 23:720-1. [PMID: 17912943 DOI: 10.3928/1081-597x-20070901-12] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To report a case of late recurrence of bilateral diffuse lamellar keratitis (DLK) after LASIK. METHODS A 39-year-old woman presented in the early postoperative period with bilateral DLK after hyperopic LASIK and was treated with topical steroids. One year after and with no obvious cause (idiopathic), recurrence of the same stage (stage III) of disease was observed. RESULTS Slit-lamp examination revealed diffuse, multifocal, and granular haze in the interface. The microbiology culture was negative. Confocal microscopy demonstrated multiple activated keratocytes, debris, and inflammatory cells adjacent to the flap interface. After intense treatment with topical corticosteroids, DLK resolved and corneal transparency was achieved with complete restoration of visual acuity. CONCLUSIONS Diffuse lamellar keratitis may recur in LASIK patients with previous episodes without an obvious cause (idiopathic). Early diagnosis and treatment with topical corticosteroids can achieve complete resolution without visual loss--even in advanced stages of DLK.
Collapse
|
21
|
Symes RJ, Catt CJ, Males JJ. Diffuse lamellar keratitis associated with gonococcal keratoconjunctivitis 3 years after laser in situ keratomileusis. J Cataract Refract Surg 2007; 33:323-5. [PMID: 17276279 DOI: 10.1016/j.jcrs.2006.09.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2006] [Accepted: 09/06/2006] [Indexed: 10/23/2022]
Abstract
A 29-year-old man presented with a 5-day history of a red eye with a purulent discharge. Three years previously, he had undergone laser in situ keratomileusis elsewhere. A diagnosis of gonococcal keratoconjuntivitis was made clinically and confirmed with culture. The patient subsequently developed diffuse lamellar keratitis (DLK). The keratoconjunctivitis and DLK resolved with antibiotic therapy and topical steroids. The cause and effect relationship of these 2 uncommon events is of interest.
Collapse
|