Diffuse lamellar keratitis after laser in situ keratomileusis with the Moria LSK-One and Carriazo-Barraquer microkeratomes.
OBJECTIVE
To assess risk factors for and incidence of diffuse lamellar keratitis (DLK) and to investigate whether microkeratome design is associated with the incidence of DLK.


METHODS
The Laser Eye Consultants of Boston, Boston and Waltham, Massachusetts, USA.


METHODS
In a retrospective nonrandomized comparative study, 1122 consecutive primary laser in situ keratomileusis (LASIK) treatments (584 patients) were analyzed to determine the incidence of DLK using 2 different microkeratome designs (Moria LSK-One [LSK] and Moria Carriazo-Barraquer [C-B]). The incidence of DLK was as determined by clinical signs.


RESULTS
The overall incidence of DLK was 2.23%. The incidence in the LSK and C-B groups was 1.09% and 4.38%, respectively, with a statistically significant difference in incidence between the 2 groups (P<.01). Epithelial irregularities increased the risk for DLK. There was no significant statistical difference in sex, age, operating room location, type of laser, or time of day the surgery was performed between the 2 groups or between eyes that had DLK and eyes without DLK. The incidence of DLK using the C-B microkeratome fell significantly after May 2000, when new cleaning methods for this device were introduced.


CONCLUSIONS
Different microkeratomes and how they are maintained may influence the incidence of DLK. Diffuse lamellar keratitis is more common after LASIK in a setting of epithelial irregularities, whether or not an actual epithelial defect is created.
Thammano
Pavika
P
The Laser Eye Consultants of Boston, Boston, Massachusetts, USA.
Rana
Azhar N
AN
Talamo
Jonathan H
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D003319:Corneal Stroma / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D007634:Keratitis / Q000175:diagnosis / Q000209:etiology*; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects* / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps / Q000473:pathology*