Delayed diffuse lamellar keratitis after laser in situ keratomileusis

Delayed diffuse lamellar keratitis after laser in situ keratomileusis
Issue online:
10 Dec 2003
To cite this article: Jonathan Yeoh MBBS, Con N Moshegov FRACO (2001)
Delayed diffuse lamellar keratitis after laser in situ keratomileusis
Clinical & Experimental Ophthalmology 29 (6), 435Ò437.
doi:10.1046/j.1442-9071.2001.d01-32.x
Blackwell Synergy

Jonathan Yeoh MBBS11Concord Repatriation General Hospital, Concord and and Con N Moshegov FRACO1,21Concord Repatriation General Hospital, Concord and 2Laser Sight Centres Australasia, Bondi Junction, New South Wales, Australia

Dr Jonathan Yeoh Concord Repatriation General Hospital, Hospital Road, Concord, NSW 2139, Australia. Email: jonyeoh@hotmail.com

ABSTRACT
Two cases are reported of delayed diffuse lamellar keratitis after uneventful laser in situ keratomileusis. The first patient presented with an epithelial defect 6 weeks after laser in situ keratomileusis. Three days later the defect was healed but diffuse lamellar keratitis was noted. This was treated with topical dexamethasone and ketorolac with complete resolution of the diffuse lamellar keratitis over 3 weeks. The second patient presented with an epithelial defect and gross diffuse lamellar keratitis 10 weeks after laser in situ keratomileusis. Treatment was with topical dexamethasone and ciprofloxacin with gradual resolution of the diffuse lamellar keratitis. Common to both patients was a background of rosacea, implanted debris with no initial reaction, and epithelial defects leading to diffuse lamellar keratitis. It is suggested that these two cases represent epithelial defect associated corneal infiltration, which resembles classical diffuse lamellar keratitis with the spread of inflammatory cells through a path of least resistance.

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