Related Experiment Video
Updated: Aug 7, 2026
Establishing a Severe Corneal Inflammation Model in Rats Based on Corneal Epithelium Curettage Combined with Corneal Sutures
Published on: November 22, 2024
Diffuse lamellar keratitis induced by toxic chemicals after laser in situ keratomileusis
Ying-Cheng Shen1, Chun-Yuan Wang, Shih-Chao Fong
1Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China. eric550131@yahoo.com.tw
Purpose:
To assess whether toxic chemicals produced during autoclaving sterilization were 1 of the main causes of diffuse lamellar keratitis (DLK) and to analyze the clinical outcomes of patients developing DLK after laser in situ keratomileusis (LASIK) treated with intensive topical corticosteroids.
Setting:
Department of Ophthalmology, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
Methods:
A total of 14 eyes of 7 patients received technically smooth LASIK and developed DLK, including 6 severe and 8 mild DLK cases. In all eyes the same microkeratome was used; it was contaminated with toxic chemical materials produced accidentally by coautoclaving instruments and a foam piece.
Results:
Six eyes of 3 patients developed severe DLK on the same day, and 8 eyes of 4 patients developed mild DLK during the next LASIK surgery. After intensive topical corticosteroid treatment, lamellar infiltrates disappeared in 3 days in mild DLK eyes and 2 weeks in severe DLK eyes. No eye was treated with flap lifting and interface irrigation. For grade 4 DLK, the corneal opacity and flap folds disappeared in 4 weeks. There were no instances of permanent corneal scarring or loss of best spectacle-corrected visual acuity.
Conclusions:
Toxic chemicals produced during instrument autoclaving sterilization are a possible cause of DLK. Immediate diagnosis and treatment with intensive corticosteroid drops are critical and can resolve severe DLK.
