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Diffuse lamellar keratitis associated with carboxymethylcellulose sodium 1% after laser in situ keratomileusis
Michael A Samuel1, Stephen C Kaufman, Jason A Ahee
1Eye Care Services, Henry Ford Health System, 2799 West Grand Boulevard K10, Detroit, MI 48202, USA.
Insights
Carboxymethylcellulose sodium 1% (Celluvisc) used during laser in situ keratomileusis (LASIK) surgery was strongly linked to diffuse lamellar keratitis (DLK). Most cases of DLK developed post-surgery and resolved with corticosteroid treatment.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Ophthalmic Surgery
Background:
- Laser in situ keratomileusis (LASIK) is a common refractive surgery.
- Diffuse lamellar keratitis (DLK) is a known complication of LASIK.
Purpose of the Study:
- To investigate the association between Celluvisc use and DLK development.
- To determine if carboxymethylcellulose sodium 1% increases DLK risk.
Main Methods:
- Retrospective case series of 30 eyes from 15 patients.
- Reviewed postoperative outcomes for LASIK patients using Celluvisc.
- Analyzed incidence and severity of DLK.
Main Results:
- 80% of eyes using Celluvisc developed DLK.
- Most DLK cases were diagnosed on postoperative day 1.
- Stage 1 DLK occurred in 66.7% of affected eyes.
Conclusions:
- Celluvisc used immediately before keratectomy is highly associated with DLK.
- Intense topical corticosteroids effectively treated DLK.
- Further research may be needed to confirm causality.
Purpose:
To investigate the association between the use of carboxymethylcellulose sodium 1% (Celluvisc) (Allergan, Inc.) during laser in situ keratomileusis (LASIK) and the development of diffuse lamellar keratitis (DLK).
Setting:
Outpatient surgery center, Detroit, Michigan, USA.
Methods:
In this retrospective case series, the postoperative clinical course and surgical outcomes in 30 eyes of 15 consecutive patients who had LASIK with the use of Celluvisc were reviewed. All patients had primary LASIK, and the incidence and severity of DLK were analyzed.
Results:
Diffuse lamellar keratitis developed in 24 of the 30 eyes (80.0%) in which Celluvisc was used before the keratectomy (P = <.0001, Fischer exact test). Sixteen eyes (66.7%) had stage 1, and 8 (33.3%) had stage 2. Diffuse lamellar keratitis was diagnosed in most cases (91.6%) on postoperative day 1. All inflammation resolved after treatment with intense topical corticosteroids.
Conclusions:
Celluvisc used immediately before the keratectomy in LASIK was highly associated with the development of DLK.
