Atopy: a patient-specific risk factor for diffuse lamellar keratitis.
OBJECTIVE
To identify whether atopy is a patient-specific risk factor for the development of diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK).


METHODS
Retrospective survey study.


METHODS
Three hundred sixty consecutive patients who underwent same-day bilateral myopic astigmatic primary LASIK procedures during March 1, 2000, through July 31, 2000.


METHODS
We collected data for 360 consecutive patients undergoing LASIK during a 4-month period. On preoperative medical history questionnaires, patients self-identified whether they were atopic. All patients also indicated whether they were taking antiallergy medications or were untreated for allergy.


METHODS
The incidence of DLK after LASIK surgery.


RESULTS
The risk of DLK in untreated atopic patients was much greater than the risk of DLK among nonatopics (odds ratio, 5.85; 95% confidence interval, 2.89-11.85; P = 0.001). However, the risk of DLK among atopic patients taking an oral systemic nonsedating histamine receptor 1 antagonist and among nonatopic patients did not differ significantly (odds ratio, 0.54; 95% confidence interval, 0.12-2.46; P = 0.43).


CONCLUSIONS
Atopy is a patient-specific risk factor for the development of DLK after primary bilateral LASIK for either myopia or myopic astigmatism. Atopic individuals benefit from preoperative treatment to minimize the incidence of DLK and the potential for visual loss.
Boorstein
Stephen M
SM
Department of Ophthalmology, Davis Duehr Dean, Madison, Wisconsin, USA. sdboor@msn.com
Henk
Henry J
HJ
Elner
Victor M
VM
D000328:Adult; D001251:Astigmatism / Q000601:surgery; D003315:Cornea / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000150:complications* / Q000175:diagnosis; D007634:Keratitis / Q000209:etiology*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D016017:Odds Ratio; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires