Wiping microkeratome blades with sterile 100% alcohol to prevent diffuse lamellar keratitis after laser in situ keratomileusis.
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.
Levinger
Samuel
S
Enaim Refractive Surgery Center, Jerusalem, Israel. ronit@enaim.co.il
Landau
David
D
Kremer
Israel
I
Merin
Saul
S
Aizenman
Isaac
I
Hirsch
Ami
A
Douieb
Joseph
J
Bos
Teunis
T
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
D000891:Anti-Infective Agents, Local; D005557:Formaldehyde; C027490:polyvinyl alcohol formaldehyde foam; D000431:Ethanol; D011142:Polyvinyl Alcohol