title: Late-onset severe diffuse lamellar keratitis associated with uveitis after LASIK in a patient with ankylosing spondylitis.
abstract: 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.
authors: Unidad de Superficie e Inflamación Ocular, Hospital Clínico Universitario San Carlos, Madrid, Spain. daviddiazvalle@yahoo.es
authors: David
authors: D
authors: Díaz-Valle
authors: Pedro
authors: P
authors: Arriola-Villalobos
authors: José M Benitez-del-Castillo
authors: JM
authors: Sánchez
authors: Enrique
authors: E
authors: Santos Bueso
authors: José M Martínez
authors: JM
authors: de la Casa
authors: Ricardo Cuiña
authors: RC
authors: Sardiña
mesh_terms: 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
chemical_list: D005938:Glucocorticoids