Incidence and outcomes of lasik with diffuse lamellar keratitis treated with topical and oral corticosteroids.
OBJECTIVE
To analyze the incidence and clinical outcomes of patients developing diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK) treated with topical and oral corticosteroids.


METHODS
Oregon Eye Institute, Eugene, Oregon, USA.


METHODS
A retrospective analysis of the last consecutive 1000 LASIK cases was performed. Eyes developing stage 3 DLK or at risk for progressing to stage 3 were treated with a combination of high-dose prednisolone acetate 1% and oral prednisone and evaluated for corneal scarring, loss of best spectacle-corrected visual acuity (BSCVA), and deviation from the intended refractive outcome.


RESULTS
Diffuse lamellar keratitis developed in 40 eyes (4%). It progressed to stage 3 in 7 eyes (17%). Oral and topical steroids were used in 22 eyes (55%). The mean variation from the desired refractive outcome was 0.14 diopter +/- 0.53 (SD). There were no instances of corneal scarring or permanent loss of BSCVA. No eye had interface irrigation.


CONCLUSIONS
Treatment of severe DLK with high-dose topical and oral corticosteroids produced excellent results without flap lifting and interface irrigation.
Hoffman
Richard S
RS
Drs. Fine, Hoffman, & Packer, LLC, 1550 Oak Street, Suite 5, Eugene, Oregon 97401, USA. rshoffman@finemd.com
Fine
I Howard
IH
Packer
Mark
M
D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007634:Keratitis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use*; D012029:Refraction, Ocular; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
D005938:Glucocorticoids; C009935:prednisolone acetate; D011239:Prednisolone; D011241:Prednisone