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Late-onset diffuse lamellar keratitis 12 years after laser in situ keratomileusis

Poster Details

First Author: M.Quiroz Quiroga SPAIN

Co Author(s):    E. Segovia   R. Falah   O. Pujol   N. Najjari   A. Matheu   J. Armentia     

Abstract Details

Purpose:

DLK is an infrequent corneal complication after LASIK surgery characterized by a sterile inflammatory respond to the interface that can have either an early or late onset. The early manifestation is the most frequent. DLK has been linked to multiple rare potential inciting factors. We report a case of late-onset diffuse lamellar keratitis (DLK) triggered by corneal erosion in the right eye of a 46 year old woman 12 years after an uncomplicated bilateral myopic laser in situ keratomileusis (LASIK).

Setting:

Department of Ophthalmology Hospital de l'Esperan├ža - Parc de Salut Mar Barcelona-Espa├▒a Patient had all her follow ups in the anterior segment department

Methods:

The patient was first referred to our hospital in order to control the evolution of corneal erosion in her right eye. She was being treated by her primary care physician with topical antibiotics ointment for several days. She referred that the pain and the red-eye were much better compared to a week earlier. However, she came referring a new onset of blurred vision in the right eye. Best-corrected visual acuity (BCVA) was 0,6. Slit-lamp examination revealed intact corneal epithelium and frank corneal haze. The anterior segment optical coherence tomography (AS-OCT) showed a diffuse infiltrate in the interface.

Results:

Based on the recent history of corneal erosion in a patient with previous LASIK and with the corneal aspect in slit lamp examination, our first diagnostic suspect was DLK. We started treatment with an intense topical steroids scheme and artificial tears. Clinical follow up confirmed the complete resolution of haze and blurred vision. Finally, five weeks later BCVA was 0,9 and the anterior segment examination showed a clear interface, without treatment complications.

Conclusions:

In conclusion, the present case and several others recently published, indicates that the interphase pathology after an uncomplicated LASIK surgery might have late onset complications that should be promptly considered and treated, in order to prevent permanent visual impairment.

Financial Disclosure:

None

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