Related Experiment Videos
Sporadic diffuse lamellar keratitis (DLK) after LASIK.
Steven E Wilson1, Renato Ambrósio
1Department of Ophthalmology, University of Washington School of Medicine, Box 356485, Seattle, WA 98195-6485, USA. sewilson@u.washington.edu
Cornea
|July 20, 2002
Summary
Sporadic diffuse lamellar keratitis (DLK) after LASIK occurs in less than 1% of eyes, often due to internal inflammation triggers. This differs from epidemic DLK, suggesting varied causes for LASIK complications.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Inflammatory Eye Disease
Background:
- Diffuse lamellar keratitis (DLK) is a known complication following laser-assisted in situ keratomileusis (LASIK).
- Understanding the etiology of sporadic DLK is crucial for differentiating it from epidemic forms and optimizing patient management.
- Previous research has focused on identifying risk factors and treatment strategies for DLK.
Purpose of the Study:
- To determine the incidence of sporadic diffuse lamellar keratitis (DLK) in a large cohort of LASIK procedures.
- To propose a hypothesis suggesting that the causes of sporadic DLK differ from those of epidemic DLK.
Main Methods:
- A retrospective analysis of 1352 primary LASIK eyes and 217 LASIK enhancement eyes.
- Documentation of the incidence and severity of DLK in all consecutive cases.
- Statistical analysis to compare DLK rates between primary and enhancement procedures.
Main Results:
- The overall incidence of DLK was 0.9% for primary LASIK and 1.4% for LASIK enhancement, with no statistically significant difference.
- All DLK cases (Stages 1 and 2) responded well to corticosteroid therapy, with additional interventions for Stage 2.
- Epithelial nests were observed in two cases; two late-onset DLK cases were associated with epithelial abrasions.
Conclusions:
- Sporadic DLK is likely triggered by endogenous factors, such as interleukin-1, leading to inflammatory cell accumulation at the LASIK interface.
- Exogenous factors, like Betadine contamination, may also contribute to sporadic DLK.
- Epidemic DLK is suspected to stem from exogenous sources like endotoxins or detergents, indicating distinct causative pathways.