title: Diffuse lamellar keratitis after small-incision lenticule extraction.
abstract: OBJECTIVE
  To determine the incidence and clinical features of diffuse lamellar keratitis (DLK) after small-incision lenticule extraction (SMILE).
  
  
  METHODS
  Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.
  
  
  METHODS
  Retrospective case control study.
  
  
  METHODS
  Small-incision lenticule extraction for myopia was performed from September 1, 2011, to October 31, 2013. Preoperative clinical characteristics; treatment parameters; and intraoperative and postoperative complications, including the incidence, severity, clinical outcome, and resolution of DLK, were recorded. The independent t test, chi-square test, univariate repeated measures, and multivariate linear regression analysis were used to make statistical comparisons between eyes that developed DLK and those that did not.
  
  
  RESULTS
  The study enrolled 1112 eyes (590 patients). Eighteen eyes (1.6%) (11 patients) developed DLK. These patients presented 1 to 3 days postoperatively with mild to moderate inflammation. Thirteen eyes (72.2%) had stage 1 DLK, 4 (22.2%) had stage 2, and 1 (5.6%) had stage 3. After intensive treatment with topical corticosteroids, the stage 1 and stage 2 cases resolved within 3 weeks and the stage 3 case resolved in 1 month. The postoperative corrected distance visual acuity was the same or better than preoperatively in all eyes. There was a statistically significant increase in the incidence of DLK with thinner lenticules (P = .02) and larger diameter lenticules (P = .01), although multifactorial analysis showed lenticule thickness to be the only factor (P = .03).
  
  
  CONCLUSIONS
  Diffuse lamellar keratitis is a potential complication after small-incision lenticule extraction, although it had a low incidence. The risk factors for DLK must be further elucidated.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors: From the Department of Ophthalmology (Zhao, He, Yao, Shen, Miao, Wang, X. Zhou), Eye and ENT Hospital of Fudan University, Myopia Key Laboratory of the Health Ministry, Shanghai, China; the Department of Ophthalmology (Z. Zhou), Bronx Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors: Jing
authors: J
authors: Zhao
authors: From the Department of Ophthalmology (Zhao, He, Yao, Shen, Miao, Wang, X. Zhou), Eye and ENT Hospital of Fudan University, Myopia Key Laboratory of the Health Ministry, Shanghai, China; the Department of Ophthalmology (Z. Zhou), Bronx Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors: Li
authors: L
authors: He
authors: From the Department of Ophthalmology (Zhao, He, Yao, Shen, Miao, Wang, X. Zhou), Eye and ENT Hospital of Fudan University, Myopia Key Laboratory of the Health Ministry, Shanghai, China; the Department of Ophthalmology (Z. Zhou), Bronx Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors: Peijun
authors: P
authors: Yao
authors: From the Department of Ophthalmology (Zhao, He, Yao, Shen, Miao, Wang, X. Zhou), Eye and ENT Hospital of Fudan University, Myopia Key Laboratory of the Health Ministry, Shanghai, China; the Department of Ophthalmology (Z. Zhou), Bronx Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors: Yang
authors: Y
authors: Shen
authors: From the Department of Ophthalmology (Zhao, He, Yao, Shen, Miao, Wang, X. Zhou), Eye and ENT Hospital of Fudan University, Myopia Key Laboratory of the Health Ministry, Shanghai, China; the Department of Ophthalmology (Z. Zhou), Bronx Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors: Zimei
authors: Z
authors: Zhou
authors: From the Department of Ophthalmology (Zhao, He, Yao, Shen, Miao, Wang, X. Zhou), Eye and ENT Hospital of Fudan University, Myopia Key Laboratory of the Health Ministry, Shanghai, China; the Department of Ophthalmology (Z. Zhou), Bronx Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors: Huamao
authors: H
authors: Miao
authors: From the Department of Ophthalmology (Zhao, He, Yao, Shen, Miao, Wang, X. Zhou), Eye and ENT Hospital of Fudan University, Myopia Key Laboratory of the Health Ministry, Shanghai, China; the Department of Ophthalmology (Z. Zhou), Bronx Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York, USA. Electronic address: xiaoyingbbb@163.com.
authors: Xiaoying
authors: X
authors: Wang
authors: From the Department of Ophthalmology (Zhao, He, Yao, Shen, Miao, Wang, X. Zhou), Eye and ENT Hospital of Fudan University, Myopia Key Laboratory of the Health Ministry, Shanghai, China; the Department of Ophthalmology (Z. Zhou), Bronx Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors: Xingtao
authors: X
authors: Zhou
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003319:Corneal Stroma / Q000601:surgery*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007634:Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008866:Microsurgery; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D005938:Glucocorticoids