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Pressure-induced interface keratitis: a late complication following LASIK
Michael L Nordlund1, Sara Grimm, Stephen Lane
1Cincinnati Eye Institute and Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, OH 45242, USA. mnordlund@cincinnatieye.cin
Cornea
|April 16, 2004
Summary
Late-onset LASIK interface inflammation can mimic DLK but worsens with steroids and is linked to high intraocular pressure. Controlling eye pressure is key for resolving this steroid-refractory inflammation.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Inflammatory Eye Disease
Background:
- Interface inflammation is a known complication following laser in situ keratomileusis (LASIK).
- Diffuse lamellar keratitis (DLK) is the most common form, typically appearing early and responding to steroids.
- A distinct presentation of late-onset inflammation requires further characterization.
Observation:
- A retrospective review identified 10 eyes (6 patients) with late-onset interface inflammation post-LASIK.
- Patients presented with inflammation resembling DLK, often already on topical steroids.
- Elevated intraocular pressure was a consistent finding, often developing after initial presentation.
Findings:
- The late-onset inflammation was refractory to aggressive topical steroid treatment.
- Steroid use appeared to exacerbate the lamellar inflammation.
- Resolution of inflammation was achieved only after controlling elevated intraocular pressure.
Implications:
- Elevated intraocular pressure may contribute to or drive late-onset LASIK interface inflammation.
- This condition is clinically distinct from classic DLK.
- Routine monitoring of intraocular pressure is crucial for patients with postoperative flap inflammation.