LASIK Complication - Diffuse Lamellar Keratitis

Diffuse lamellar keratitis (DLK) is one of the most common complications of LASIK Eye Surgery. The DLK's nickname is Sands of the Sahara and reported incidence ranges from 0.7% - 32%.

Diffuse lamellar keratitis, if it is to present, is almost always seen on the first day after LASIK Eye Surgery, It is characterized by a diffuse white, granular infiltrate occurring within a few days after LASIK. Patients report decreased vision, photophobia, decreased pain, and foreign body sensation.

LASIK

There are four stages of diffuse lamellar keratitis (DLK) :

Stage 1 : The central cornea is not affected.

Generally appears shortly after LASIK Eye Surgery and consists of the presence of foreign matter in the periphery of the corneal flap.

Stage 2 : Foreign material migrates to visual axis central.

This stage occurs a few days after the condition starts developing. As dense clumps of cells collect on your central visual axis, the disorder begins transitioning into stage 3.

Stage 3 : Experience a 1 or 2 line loss of visual acuity.

Your eyes may begin to develop permanent scarring if they are not treated.

Stage 4 : Central tissue loss may lead to the development of hyperopia in your vision.

The condition has become very severe. Patients often experience stromal melting and permanent scarring. It is rare that DLK progresses to this stage without treatment.

Reasons of Diffuse Lamellar Keratitis (DLK) after Lasik

The etiology of DLK is still a mystery. The exact cause of this noninfectious condition is still unknown. Proposed causes of DLK include deposits from microkeratome blades, particles from the eye drape, epithelial defects, meibomian secretions, surgical glove talc, debris from surgical sponges, and contamination of reservoir sterilizers by gram-negative endotoxins.

Treatment to Diffuse Lamellar Keratitis (DLK) after Lasik

Treatment is normally topical and oral medication such as antibiotics and topical steroids. Generally consists of anti-inflammatory eye drops that must be used frequently for several months. Sometimes it is necessary to lift the flap, remove some of the infiltrates, irrigate the area, and reposition the flap. Early diagnosis and prompt treatment is crucial to preventing permanent vision loss.