LASIK flap interface deposition in limbal vernal keratoconjunctivitis

Area of Science:

• Ophthalmology
• Allergic Eye Diseases
• Corneal Surgery

Background:

• Limbal vernal keratoconjunctivitis (VKC) is a chronic allergic eye condition typically affecting young males.
• It presents with limbal papillae and superficial keratitis, potentially causing permanent corneal damage if untreated.
• Laser-assisted in situ keratomileusis (LASIK) is a common refractive surgery procedure.

Observation:

• A 25-year-old male with a history of bilateral LASIK developed recurrent red, itchy eyes.
• Slitlamp examination revealed limbal chemosis, superficial keratitis, and distinct yellow-white deposits along the LASIK flap interface.
• These findings suggested limbal VKC with an atypical corneal response post-LASIK.

Findings:

• The patient was diagnosed with limbal VKC superimposed on a cornea with a history of LASIK.
• Intensive topical steroid treatment effectively resolved the limbal and corneal inflammation.
• The characteristic yellow-white deposition at the LASIK flap interface remained unchanged despite treatment.

Implications:

• This case highlights a potential for altered corneal responses in patients with a history of LASIK who develop allergic eye conditions like VKC.
• The persistent deposition suggests a unique interaction between the allergic process and the LASIK-induced corneal changes.
• Further research may be needed to understand the long-term implications and management of such presentations.