title: Bilateral marginal sterile infiltrates and diffuse lamellar keratitis after laser in situ keratomileusis.
abstract: OBJECTIVE
  To report cases of acute bilateral catarrhal infiltrates in the early postoperative period after laser in situ keratomileusis (LASIK).
  
  
  METHODS
  Retrospective review of both eyes of two patients.
  
  
  RESULTS
  Two patients developed acute bilateral, marginal, catarrhal infiltrates in the early postoperative period after LASIK. Both patients had moderate to severe chronic meibomian gland dysfunction preoperatively. One patient (both eyes) developed grade 3 diffuse lamellar keratitis (DLK) that required both flaps to be lifted for irrigation and cleaning on postoperative day 5. Fungal and bacterial cultures were negative in both eyes of both patients. The condition resolved with intensive topical corticosteroids and fortified antibiotics. Regression of refractive error and the need for enhancement was encountered in all eyes. There was mild recurrence in one eye of each patient with pretreatment with topical corticosteroids prior to enhancement.
  
  
  CONCLUSIONS
  Endogenous factors such as chronic blepharitis and meibomian gland dysfunction may trigger inflammation resulting in sporadic cases of catarrhal infiltrates after LASIK. These patients may have chronic inflammatory milieus that can trigger sporadic cases of catarrhal infiltrates after LASIK, with accompanying diffuse lamellar keratitis.
authors.affiliation: Department of Ophthalmology, University of Washington, Seattle, WA 98195, USA.
authors.forename: Renato
authors.initials: R
authors.lastname: Ambrósio
authors.forename: Laura M
authors.initials: LM
authors.lastname: Periman
authors.forename: Marcelo V
authors.initials: MV
authors.lastname: Netto
authors.forename: Steven E
authors.initials: SE
authors.lastname: Wilson
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001251:Astigmatism / Q000601:surgery; D003315:Cornea / Q000473:pathology* / Q000601:surgery; D019573:Epithelium, Corneal; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007634:Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D011183:Postoperative Complications; D016896:Treatment Outcome; D014792:Visual Acuity; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D009883:Ophthalmic Solutions