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Christian Khairallah, Fernando Heitor de Paula, Carly Guss, Leslie M. Niziol, David C. Musch, Roni M. Shtein; Diffuse Lamellar Keratitis After LASIK With Femtosecond Laser Flap Creation. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5788.
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© ARVO (1962-2015); The Authors (2016-present)
To identify possible associations with the development of diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK) with femtosecond laser flap creation.
This retrospective case series compares 683 eyes of 355 consecutive patients who underwent myopic LASIK surgery between October 25, 2006, and February 16, 2010, using the IntraLase 60 kHz femtosecond laser for flap creation. Preoperative clinical characteristics, treatment parameters, intraoperative and postoperative complications were recorded. Statistical comparisons were made using t-tests, chi-square tests, Fisher's exact tests, and repeated measures logistic regression to adjust for inter-eye dependency.
Ninety seven (14%) eyes of 68 patients developed DLK, 29 bilateral and 39 unilateral. Most cases of DLK represented mild flap interface inflammation, with only 16 eyes requiring more than 1 week of anti-inflammatory treatment. There was a statistically significant increase in the incidence of DLK with larger flap diameter (P = .0225). Patients with DLK tended to be less likely to achieve best corrected visual acuity of 20/20 or better on the first postoperative day and at one week, but in no case was the difference statistically significant. There were no significant associations between the incidence of DLK and preoperative refractive error, flap thickness, ablation depth, or other treatment parameters.
DLK after LASIK with femtosecond laser flap creation tends to be mild, with minimal effect on visual acuity. Larger flap diameter, with increased proximity to the limbus, is associated with increased risk of developing DLK.
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