Bilateral diffuse lamellar keratitis following bilateral simultaneous versus sequential laser in situ keratomileusis

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Inflammation

Background:

• Diffuse lamellar keratitis (DLK) is a potential complication following laser in situ keratomileusis (LASIK).
• Understanding the incidence and risk factors for DLK is crucial for patient safety and surgical outcomes.

Purpose of the Study:

• To compare the incidence of bilateral DLK in patients undergoing simultaneous versus sequential bilateral LASIK.
• To investigate whether surgical timing indicates an intrinsic risk for DLK.

Main Methods:

• Retrospective case series of 1632 eyes undergoing bilateral LASIK (simultaneous or sequential).
• Identified and reviewed cases of clinically evident DLK.
• Excluded cases with suspected environmental or epidemic causes to isolate non-epidemic DLK.

Main Results:

• 126 eyes (7.7%) developed DLK. 16 of 94 eligible patients (17.0%) had bilateral DLK.
• Incidence of bilateral DLK was 14.6% in the simultaneous group and 18.9% in the sequential group (p > 0.5).
• No statistically significant difference in bilateral DLK incidence between simultaneous and sequential LASIK.

Conclusions:

• Bilateral DLK incidence is similar for both simultaneous and sequential LASIK procedures.
• The findings suggest an intrinsic, rather than procedural, factor may predispose patients to DLK.
• Further research into underlying host factors for DLK is warranted.