Confocal microscopy in late-onset diffuse lamellar keratitis after laser in situ keratomileusis

This article reports a case of diffuse lamellar keratitis, without exposure of the flap interface, that developed in a patient who underwent intraepithelial photorefractive keratectomy 1 year after bilateral LASIK. Confocal microscopy was performed in both eyes at the onset of the diffuse lamellar keratitis and after its resolution. In the eye with diffuse lamellar keratitis, abundant round structures (inflammatory cells) were present at the interface; these structures disappeared after the keratitis resolved and were not present in the contralateral eye at any time. These confocal microscopic findings further support the hypothesis that diffuse lamellar keratitis is a nonspecific inflammatory response in corneas with a lamellar interface.