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Sterile interface keratitis associated with micropannus hemorrhage after laser in situ keratomileusis
S MacRae1, D C Macaluso, L F Rich
1Casey Eye Institute, Oregon Health Sciences University, Portland 97201-4197, USA.
Abstract:
Numerous etiologies have been suspected to lead to sterile interface keratitis after laser in situ keratomileusis. This tan interface haze with a rippled appearance has been called Sands of the Sahara. We present 2 cases in which red blood cells entered the interface after a small hemorrhage from peripheral corneal vascularization during the microkeratome pass. Although this bleeding was controlled and all visible blood cells were removed at surgery, both patients developed the appearance of a focal interface keratitis on the first postoperative day.
Insights
Sands of the Sahara, a tan haze after laser eye surgery, may be caused by red blood cells entering the corneal interface. This finding suggests a new etiology for sterile interface keratitis following laser in situ keratomileusis.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Laser Vision Correction
Background:
- Sterile interface keratitis (SIK) is a potential complication after laser in situ keratomileusis (LASIK).
- The "Sands of the Sahara" (SoS) is a descriptive term for a tan, rippled haze observed at the LASIK interface.
Observation:
- Two cases are presented where red blood cells entered the LASIK interface.
- This entry occurred secondary to minor bleeding from peripheral corneal vascularization during the microkeratome pass.
Findings:
- Despite controlling bleeding and removing visible blood intraoperatively, both patients developed focal interface keratitis.
- The clinical presentation was consistent with the "Sands of the Sahara" appearance.
Implications:
- Red blood cell contamination of the interface is a potential, previously unrecognized cause of SIK and SoS.
- This highlights the importance of meticulous surgical technique to prevent even minor intraoperative hemorrhages in LASIK.
