LASIK interface keratitis: epidemiology, diagnosis and care

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Surgery

Background:

• Diffuse lamellar keratitis (DLK) is a frequent interface complication following laser in-situ keratomileusis (LASIK).
• Distinguishing DLK from infectious keratitis is crucial due to differing treatment protocols.
• DLK diagnosis can be challenging, necessitating a thorough understanding of its characteristics.

Purpose of the Study:

• To review the current knowledge on the epidemiology, diagnosis, and treatment of diffuse lamellar keratitis (DLK).
• To assess the challenges in differentiating DLK from other interface complications after LASIK.
• To provide an overview of management strategies for DLK.

Main Methods:

• Literature review of studies on diffuse lamellar keratitis (DLK) post-LASIK.
• Analysis of epidemiological data, diagnostic criteria, and treatment outcomes for DLK.
• Synthesis of current understanding regarding risk factors and clinical presentation of DLK.

Main Results:

• DLK can manifest in the immediate postoperative period or as late-onset cases, sometimes occurring in outbreaks linked to exogenous factors.
• Late-onset DLK is often associated with specific inciting factors, with increasing reports of later onset over time.
• Good visual outcomes are typical for DLK when diagnosed promptly and treated effectively with corticosteroids and potential interface irrigation.

Conclusions:

• Diffuse lamellar keratitis (DLK) is a well-documented complication of LASIK surgery.
• Established risk factors and treatment algorithms exist, but further research is needed.
• Evidence-based treatment advancements for DLK will benefit patient care and outcomes.