Department of Ophthalmology, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.
BMC Ophthalmol. 2022 Sep 7;22(1):362. doi: 10.1186/s12886-022-02589-3.
To present a case with a history of laser in situ keratomileusis (LASIK) developing diffuse lamellar keratitis (DLK) after diamond burr superficial keratectomy (DBSK) for recurrent corneal erosion (RCE).
A 25-year-old man presented with multiple episodes of RCE one year after femtosecond-assisted LASIK for myopia correction. Because conservative treatments failed to halt the repetitive attack of RCE, he underwent epithelial debridement and DBSK. However, severe foreign body sensation and blurred vision developed on postoperative day one. The next day, slit lamp biomicroscopy revealed DLK manifested as diffuse granular infiltrates at the flap interface. After topical corticosteroid treatment, the inflammation resolved gradually, and his vision recovered to 20/20.
Diffuse lamellar keratitis is a rare post-LASIK complication that can be triggered by DBSK, which causes impairment of the corneal epithelial integrity and subsequent inflammation at the flap interface. For post-LASIK patients with RCE, alternative treatments, such as anterior stromal puncture, may be considered to avoid extensive disruption of corneal epithelium and DLK development depending on the size and the location of the lesions.
介绍一例既往行准分子激光原位角膜磨镶术（LASIK）治疗近视，一年后因复发性角膜上皮糜烂（RCE）行钻石刀板层角膜磨镶术（DBSK）后发生弥漫性层间角膜炎（DLK）的病例。
一名 25 岁男性，行飞秒激光辅助 LASIK 治疗近视一年后，多次发生 RCE。由于保守治疗未能阻止 RCE 的反复发作，他接受了上皮清创术和 DBSK。然而，术后第一天出现严重的异物感和视力模糊。第二天，裂隙灯生物显微镜检查显示 DLK 表现为瓣间弥漫性颗粒状浸润。经局部皮质类固醇治疗后，炎症逐渐消退，视力恢复至 20/20。
弥漫性层间角膜炎是 LASIK 术后罕见的并发症，DBSK 可引发该并发症，导致角膜上皮完整性受损和随后瓣间炎症。对于 LASIK 术后 RCE 患者，根据病变的大小和位置，可考虑采用前弹力层穿刺等替代治疗方法，以避免广泛破坏角膜上皮和 DLK 的发生。
