title: Diffuse lamellar keratitis associated with carboxymethylcellulose sodium 1% after laser in situ keratomileusis.
abstract: OBJECTIVE
  To investigate the association between the use of carboxymethylcellulose sodium 1% (Celluvisc) (Allergan, Inc.) during laser in situ keratomileusis (LASIK) and the development of diffuse lamellar keratitis (DLK).
  
  
  METHODS
  Outpatient surgery center, Detroit, Michigan, USA.
  
  
  METHODS
  In this retrospective case series, the postoperative clinical course and surgical outcomes in 30 eyes of 15 consecutive patients who had LASIK with the use of Celluvisc were reviewed. All patients had primary LASIK, and the incidence and severity of DLK were analyzed.
  
  
  RESULTS
  Diffuse lamellar keratitis developed in 24 of the 30 eyes (80.0%) in which Celluvisc was used before the keratectomy (P = <.0001, Fischer exact test). Sixteen eyes (66.7%) had stage 1, and 8 (33.3%) had stage 2. Diffuse lamellar keratitis was diagnosed in most cases (91.6%) on postoperative day 1. All inflammation resolved after treatment with intense topical corticosteroids.
  
  
  CONCLUSIONS
  Celluvisc used immediately before the keratectomy in LASIK was highly associated with the development of DLK.
authors.affiliation: Eye Care Services, Henry Ford Health System, 2799 West Grand Boulevard K10, Detroit, MI 48202, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Samuel
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Kaufman
authors.forename: Jason A
authors.initials: JA
authors.lastname: Ahee
authors.forename: Curtis
authors.initials: C
authors.lastname: Wee
authors.forename: David
authors.initials: D
authors.lastname: Bogorad
mesh_terms: D000328:Adult; D002266:Carboxymethylcellulose Sodium / Q000009:adverse effects*; D006801:Humans; D007634:Keratitis / Q000139:chemically induced* / Q000188:drug therapy; D020731:Keratomileusis, Laser In Situ; D008875:Middle Aged; D011239:Prednisolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011300:Preoperative Care / Q000009:adverse effects*; D012189:Retrospective Studies
chemical_list: C009935:prednisolone acetate; D011239:Prednisolone; D002266:Carboxymethylcellulose Sodium