Diffuse lamellar keratitis and flap margin epithelial healing after laser in situ keratomileusis.

PURPOSE

To evaluate whether wound healing of the corneal epithelium at the flap margin influences development of diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK).

METHODS

We examined prospectively 1928 eyes of 994 patients after LASIK. Condition of wound healing at the flap margin 1 day after LASIK was graded as gutter score from 0 to 3, according to the extent of fluorescein staining. Existence of DLK, gutter score, and the location of DLK and gutter were evaluated.

RESULTS

Sixty-eight eyes (3.5%) developed DLK. The average gutter score was significantly higher in patients with DLK compared to those without DLK (P<.001). The location of DLK was identical to the location of gutter in 44 eyes (77.2%).

CONCLUSION

Disruption of integrity of the epithelial barrier function at the flap margin was associcated with diffuse lamellar keratitis after laser in situ keratomileusis.