title: Cleaning solutions as a cause of diffuse lamellar keratitis.
abstract: OBJECTIVE
  To assess the capability of two microkeratome cleaning solutions in causing diffuse lamellar keratitis (DLK) in a rabbit model of laser in situ keratomileusis (LASIK).
  
  
  METHODS
  Two cleaning solutions (Palmolive 2:100 and Cidezyme 2:250) were tested. These solutions were diluted with balanced salt solution according to directions from the Hansatome microkeratome manual. Two additional solutions were prepared using an additional ten-fold dilution, creating a total of four study solutions. A LASIK flap was created in one eye each of 25 rabbits using the ALK Chiron microkeratome. The rabbits were divided into five study groups. The flaps were reflected and a drop of one of the study solutions (or BSS, control group) was placed on the interface. After 1 minute, the solution was washed out from the interface and the flap was repositioned. The eyes were examined at the slit lamp on postoperative days 1, 2, 3, 5, and 7.
  
  
  RESULTS
  In 12 eyes, a flap displacement was identified. Four eyes showed flap retraction and five others, epithelial ingrowth in flap margins. The incidence of these events did not differ among groups. Thirteen eyes were then evaluated for DLK. No DLK-like interface inflammation was seen in the studied eyes.
  
  
  CONCLUSIONS
  The cleaning solutions, when diluted as recommended by the microkeratome manufacturer, when in contact with the corneal stroma, and provided that the interface was washed with BSS did not cause DLK interface inflammation in rabbit LASIK models.
authors.affiliation: Excimer Laser Hospital Santa Cruz, São Paulo, Brazil. mayuminakano@uol.com.br
authors.forename: Eliane Mayumi
authors.initials: EM
authors.lastname: Nakano
authors.forename: Kozo
authors.initials: K
authors.lastname: Nakano
authors.forename: Marivaldo Castro
authors.initials: MC
authors.lastname: Oliveira
authors.forename: Waldir
authors.initials: W
authors.lastname: Portellinha
authors.forename: Rosangela
authors.initials: R
authors.lastname: Simonelli
authors.forename: Lênio Souza
authors.initials: LS
authors.lastname: Alvarenga
mesh_terms: D000818:Animals; D003319:Corneal Stroma / Q000187:drug effects*; D003902:Detergents / Q000009:adverse effects*; D007634:Keratitis / Q000139:chemically induced*; D020731:Keratomileusis, Laser In Situ; D011817:Rabbits; D054140:Refractive Surgical Procedures; D013524:Surgical Flaps
chemical_list: D003902:Detergents