Diffuse lamellar keratitis and flap margin epithelial healing after laser in situ keratomileusis.
OBJECTIVE
To evaluate whether wound healing of the corneal epithelium at the flap margin influences development of diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK).


METHODS
We examined prospectively 1928 eyes of 994 patients after LASIK. Condition of wound healing at the flap margin 1 day after LASIK was graded as gutter score from 0 to 3, according to the extent of fluorescein staining. Existence of DLK, gutter score, and the location of DLK and gutter were evaluated.


RESULTS
Sixty-eight eyes (3.5%) developed DLK. The average gutter score was significantly higher in patients with DLK compared to those without DLK (P<.001). The location of DLK was identical to the location of gutter in 44 eyes (77.2%).


CONCLUSIONS
Disruption of integrity of the epithelial barrier function at the flap margin was associcated with diffuse lamellar keratitis after laser in situ keratomileusis.
Asano-Kato
Naoko
N
Minamiaoyama Eye Clinic, Tokyo, Japan. naokato@bc.iij4u.or.jp
Toda
Ikuko
I
Tsuruya
Tomoko
T
Takano
Yoji
Y
Tsubota
Kazuo
K
D000328:Adult; D003287:Contrast Media; D019573:Epithelium, Corneal / Q000503:physiopathology*; D005260:Female; D019793:Fluorescein; D006801:Humans; D015994:Incidence; D007634:Keratitis / Q000209:etiology* / Q000503:physiopathology; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D013524:Surgical Flaps; D014792:Visual Acuity; D014945:Wound Healing / Q000502:physiology*
D003287:Contrast Media; D019793:Fluorescein