Diffuse Lamellar Keratitis Induced by a Corneal Foreign Body Six Months after Femto-LASIK

Background

This case report illustrates a late onset of diffuse lamellar keratitis (DLK, “Sands of Sahara”) triggered by a foreign body removal six months after laser in situ keratomileusis (LASIK).

DLK is a known interface complication after LASIK [1]. DLK mostly occurs in the immediate postoperative period but also late onset cases have been described [2]. An incidence of less than 3 % has been reported by most series reports [3]. The etiology of DLK is not well understood [4] but seems multifactorial [5]. Contributing factors to this non-infectious, inflammatory process are ocular inflammatory disease, epithelial defects or atopic disease [1]. However, late onset cases are most often related to inciting factors (flap dislocation, epithelial defects often related to recurrent erosions) [1].

• References

• 1 Gritz DC. LASIK interface keratitis: epidemiology, diagnosis and care. Curr Opin Ophthalmol 2011; 22: 251-155
• 2 Weisenthal RW. Diffuse lamellar keratitis induced by trauma 6 months after laser in situ keratomileusis. J Refract Surg 2000; 16: 746-751
• 3 De Paula FH, Khairallah CG, Niziol LM et al. Diffuse lamellar keratitis after laser in situ keratomileusis with femtosecond laser flap creation. J Cataract Refract Surg 2012; 38: 1014-1019
• 4 Johnson JD, Harissi M, Rineda R et al. Diffuse lamellar keratitis: incidence, associations, outcomes and a new classification system. J Cataract Refract Surg 2001; 27: 1560-1566
• 5 Iskander NG, Peters NT, Anderson EE et al. Postoperative complications in LASIK. Curr Opin Ophthalmol 2000; 11: 273-279
• 6 MacRae SM, Rich LF, Macaluso DC. Treatment of interface keratitis with oral corticosteroids. J Cataract Refract Surg 2002; 28: 454-461