Bilateral Peripheral Infiltrative Keratitis Following Uneventful Femtolasik

The purpose of this report is to present a case of bilateral peripheral infiltrate observed between the flap edge and limbus, which manifested on the first postoperative day after uneventful FemtoLASIK.

Department of Cornea and Refractive surgery in a Tertiary care centre

A 39-year-old man underwent uneventful bilateral simultaneous FemtoLASIK and subsequently developed a thick band of infiltrate between the flap margin and limbus. In the right eye, the infiltrate extended from 4 o'clock to 10 o'clock, while in the left eye, it spanned from 2 o'clock to 7 o'clock, exhibiting a classic lucid interval between the limbus and infiltrate and involving flap edges. The infiltrate was more prominent at the periphery, gradually fading towards the center, and diffusely progressing into the interface, resulting in typical diffuse lamellar keratitis. The infiltrate exhibited a positive response to treatment with topical prednisolone acetate 1% eye drops, systemic oral steroids, and fortified cefazolin eye drops. As the flap edges were affected and there was a favorable response to steroids, no scraping was performed. The diffuse lamellar keratitis resolved within 2 weeks, and the patient maintained good visual acuity throughout the entire treatment period.

The condition observed in this case was identified as LASIK-induced bilateral peripheral infiltrative keratitis, attributed to an immune-mediated etiology