[Diffuse lamellar keratitis after laser in situ keratomileusis. Clinical and confocal microscopy findings].
BACKGROUND
Diffuse lamellar keratitis (DLK) is a sterile inflammation after lamellar corneal surgery. A clinical staging for DLK was recently set up. In this observational case series, the clinical and confocal microscopic findings of stages 1-3 are reported.


METHODS
Six eyes of six patients (three eyes with DLK stage 1, two eyes with DLK stage 2, and one eye with DLK stage 3) were examined by slit lamp biomicroscopy and confocal microscopy.


RESULTS
In all cases, confocal microscopy showed an infiltration of inflammatory cells into the anterior stroma and the flap interface. The number of cells varied between the eyes with DLK stage 1, and both stage 2 corneas had dense infiltrates. In the eye with stage 3 DLK, an aggregation of decayed cells, most likely granulocytes, was noticed clinically and by confocal microscopy.


CONCLUSIONS
The DLK stages represent different clinical intensities of interface inflammation after LASIK. While stages 1 and 2 have a similar confocal microscopic appearance, stage 3 is a result of aggregation of a high amount of inflammatory cells.
Bühren
J
J
Klinik für Augenheilkunde, Johann Wolfgang Goethe-Universität, Theodor-Stern-Kai 7, 60590 Frankfurt am Main.
Cichocki
M
M
Baumeister
M
M
Kohnen
T
T
D000328:Adult; D005260:Female; D006801:Humans; D007634:Keratitis / Q000175:diagnosis / Q000209:etiology*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D013997:Time Factors; D014792:Visual Acuity
Diffuse lamelläre Keratitis (DLK) nach Laser-in-situ-Keratomileusis. Klinische und konfokalmikroskopische Befunde.