Late-onset severe diffuse lamellar keratitis associated with uveitis after LASIK in a patient with ankylosing spondylitis.
To report a case of diffuse lamellar keratitis (DLK) associated with acute anterior uveitis that occurred 3 years after uneventful LASIK in a patient with a history of ankylosing spondylitis and recurrent acute anterior uveitis.



A 36-year-old man presented with pain and decreased vision in the left eye. Left eye visual acuity was 20/100. He had undergone bilateral LASIK 3 years prior to presentation to treat moderate myopia.



Slit-lamp examination revealed aqueous flare and cells, vertical corneal folds, and cell aggregates at the central interface. Flattening and thinning of the cornea were observed with Pentacam (Oculus Optikgeräte GmbH). Diffuse lamellar keratitis stage III was diagnosed and intensive corticosteroid and anticollagenolytic treatment was started with satisfactory results.



Acute anterior uveitis may be a predisposing factor for late-onset DLK after LASIK surgery. Indication of LASIK in patients at high risk of developing recurrent flares of acute anterior uveitis, such as those with spondyloarthropathies, should be carefully considered.
Díaz-Valle
David
D
Unidad de Superficie e Inflamación Ocular, Hospital Clínico Universitario San Carlos, Madrid, Spain. daviddiazvalle@yahoo.es
Arriola-Villalobos
Pedro
P
Sánchez
José M Benitez-del-Castillo
JM
Santos Bueso
Enrique
E
de la Casa
José M Martínez
JM
Sardiña
Ricardo Cuiña
RC
D000328:Adult; D019781:Corneal Topography; 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; D009216:Myopia / Q000150:complications / Q000601:surgery; D012008:Recurrence; D012307:Risk Factors; D013167:Spondylitis, Ankylosing / Q000150:complications*; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014792:Visual Acuity
D005938:Glucocorticoids