Diffuse lamellar keratitis in the femtosecond-assisted LASIK flap tunnel

Abstract

George D Kymionis,1,2 Konstantinos I Tsoulnaras,1 Nikolaos G Tsakalis,1 Michael A Grentzelos1 1Vardinoyiannion Eye Institute of Crete, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece; 2Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA Abstract: Here we report a case of a 29-year-old myopic female who underwent femtosecond laser-assisted in situ keratomileusis (LASIK) and, on the first postoperative day slit-lamp examination revealed a dense, white, granular reaction with the presence of some blood droplets (stage I diffuse lamellar keratitis [DLK]) in her left eye, specifically localized into the femtosecond LASIK flap tunnel (not extended to the flap interface). The patient received intensive treatment with topical corticosteroids and 5 days later the granular reaction had completely resolved. A new site of DLK, ie, the flap tunnel, in femtosecond-assisted LASIK is presented. DLK into the flap tunnel could be managed with corticosteroids if detected early, without affecting the flap interface. Keywords: diffuse lamellar keratitis, laser-assisted in situ keratomileusis, femtosecond, corneal vascularization, flap, tunnel