title: Wiping microkeratome blades with sterile 100% alcohol to prevent diffuse lamellar keratitis after laser in situ keratomileusis.
abstract: OBJECTIVE
  To report our experience in preventing diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK) by wiping the microkeratome blade with sterile 100% alcohol.
  
  
  METHODS
  Enaim Refractive Surgery Center, Jerusalem, Israel.
  
  
  METHODS
  Laser in situ keratomileusis was performed in 24 patients (48 eyes) on the same day by the same surgeon. The environment and instruments were identical in all cases. A new blade was used in both eyes of each patient. All blades were from the same batch and were randomly assigned to 2 groups. In the alcohol group, 12 blades were wiped with a Merocel surgical spear (Medtronic Solan) dipped in 100% alcohol and rinsed with balanced salt solution (BSS) before they were mounted in a Hansatome microkeratome (Bausch & Lomb Co.); in the control group, 12 blades were wiped with a Merocel surgical spear dipped in BSS and rinsed with BSS. All patients were examined on the first postoperative day.
  
  
  RESULTS
  Grade I to II DLK was diagnosed in 7 eyes of 4 patients in the control group (29%). No DLK was diagnosed in the alcohol group.
  
  
  CONCLUSIONS
  Wiping the microkeratome blade with 100% alcohol before mounting may remove a substance from the manufacturing or sterilization process that can cause DLK.
authors: Enaim Refractive Surgery Center, Jerusalem, Israel. ronit@enaim.co.il
authors: Samuel
authors: S
authors: Levinger
authors: David
authors: D
authors: Landau
authors: Israel
authors: I
authors: Kremer
authors: Saul
authors: S
authors: Merin
authors: Isaac
authors: I
authors: Aizenman
authors: Ami
authors: A
authors: Hirsch
authors: Joseph
authors: J
authors: Douieb
authors: Teunis
authors: T
authors: Bos
mesh_terms: D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D004203:Disinfection / Q000379:methods*; D000431:Ethanol / Q000627:therapeutic use*; D005557:Formaldehyde; D006801:Humans; D007634:Keratitis / Q000209:etiology / Q000517:prevention & control*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects / Q000295:instrumentation*; D011142:Polyvinyl Alcohol; D013525:Surgical Instruments
chemical_list: D000891:Anti-Infective Agents, Local; D005557:Formaldehyde; C027490:polyvinyl alcohol formaldehyde foam; D000431:Ethanol; D011142:Polyvinyl Alcohol