Abstract
Diffuse lamellar keratitis (DLK) is an inflammatory condition that occurs in up to 4 % of LASIK treatments. It is characterized by the presence of white granular noninfectious sterile infiltrates in the LASIK flap interface. The condition usually presents postoperatively on days 1–5 and typically starts at the periphery of the flap and progresses centrally. The syndrome is also known as “Sands of the Sahara,” as the shifting wavelike progression of the cellular infiltrates simulates shifting sands. The syndrome was first described by Maloney in 1998 and later classified into stages by Linebarger et al. in 2000 based on the location and severity of inflammation [1, 2].
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References
Smith RJ, Maloney RK (1998) Diffuse lamellar keratitis. A new syndrome in lamellar refractive surgery. Ophthalmology 105:1721–1726
Linebarger EJ, Hardten DR, Lindstrom RL (2000) Diffuse lamellar keratitis: diagnosis and management. J Cataract Refract Surg 26:1072–1077
Johnson JD, Harissi-Dagher M, Pineda R, Yoo S, Azar DT (2001) Diffuse lamellar keratitis: incidence, associations, outcomes, and a new classification system. J Cataract Refract Surg 27:1560–1566
Sonmez B, Maloney RK (2007) Central toxic keratopathy: description of a syndrome in laser refractive surgery. Am J Ophthalmol 143:420–427
Hainline BC, Price MO, Choi DM, Price FW Jr (2007) Central flap necrosis after LASIK with microkeratome and femtosecond laser created flaps. J Refract Surg 23:233–242
Belin MW, Hannush SB, Yau CW, Schultze RL (2002) Elevated intraocular pressure-induced interlamellar stromal keratitis. Ophthalmology 109:1929–1933
Lazaro C, Perea J, Arias A (2006) Surgical-glove-related diffuse lamellar keratitis after laser in situ keratomileusis: long-term outcomes. J Cataract Refract Surg 32:1702–1709
Hadden OB, McGhee CN, Morris AT, Gray TB, Ring CP, Watson AS (2008) Outbreak of diffuse lamellar keratitis caused by marking-pen toxicity. J Cataract Refract Surg 34:1121–1124
Stulting RD, Randleman JB, Couser JM, Thompson KP (2004) The epidemiology of diffuse lamellar keratitis. Cornea 23:680–688
Villarrubia A, Palacín E, Gómez del Río M, Martínez P (2007) Description, etiology, and prevention of an outbreak of diffuse lamellar keratitis after LASIK. J Refract Surg 23:482–486
Kymionis GD, Bouzoukis DI, Diakonis VF, Portaliou DM, Pallikaris AI, Yoo SH (2007) Diffuse lamellar keratitis after corneal crosslinking in a patient with post-laser in situ keratomileusis corneal ectasia. J Cataract Refract Surg 33:2135–2137
Davis EA, Fahmy AM (2009) Stage III diffuse lamellar keratitis following conductive keratoplasty over a LASIK flap. J Cataract Refract Surg 35:1141–1143
Holz H, Pirouzian A (2010) Bilateral diffuse lamellar keratitis following consecutive selective laser trabeculoplasty in LASIK patient. J Cataract Refract Surg 36:847–849
de Paula FH, Khairallah CG, Niziol LM, Musch DC, Shtein RM (2012) Diffuse lamellar keratitis after laser in situ keratomileusis with femtosecond laser flap creation. J Cataract Refract Surg 38:1014–1019
Choe CH, Guss C, Musch DC, Niziol LM, Shtein RM (2010) Incidence of diffuse lamellar keratitis after LASIK with 15 KHz, 30 KHz, and 60 KHz femtosecond laser flap creation. J Cataract Refract Surg 36:1912–1918
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Weisberg, M. (2015). DLK Early. In: Alió, J., Azar, D., Abbouda, A., Aswad, A. (eds) Difficult and Complicated Cases in Refractive Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55238-0_35
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DOI: https://doi.org/10.1007/978-3-642-55238-0_35
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