Two Cases Of Severe Diffuse Interlaminar Keratitis Progressing After Femtosecond Laser Lasik
Published 2025 - 43rd Congress of the ESCRS
Reference: PO243 | Type: Case Report | DOI: 10.82333/05z3-2907
Authors: Li Jing* 1 , Shengsheng Wei 1
1Xi’an People’s Hospital (Xi'an Fourth Hospital), Xi’an,China
Purpose
The purpose of this report is to analyze two severe DLK cases to assess the effects of personalized and combined treatment regimens in different clinical settings, as well as their impact on treatment efficacy and prognosis.
Setting
We present two severe cases of diffuse lamellar keratitis (DLK) following femtosecond laser-assisted in situ keratomileusis (Femto-LASIK). This report details the clinical presentation, diagnostic process, and individualized treatment plans for both patients, emphasizing the need for personalized and comprehensive approaches to DLK management.
Report of case
Case 1: A 24-year-old female developed blurred vision one day after surgery. Slit-lamp examination revealed a dense, white granular cellular reaction in her right eye, diagnosed as DLK (+++). The patient was treated with 0.1% flumethasone, administered six times per day. Case 2: A 24-year-old male experienced foreign body sensation, pain, photophobia, and blurred vision in his right eye on the first postoperative day. Slit-lamp examination showed white granular clouding between the corneal layers, diagnosed as DLK (++++). The patient was treated with 0.1% flumethasone, administered ten times per day. Both patients received timely diagnoses and aggressive treatment; however, their responses differed. One patient's symptoms were well-controlled, while the other showed no improvement, ultimately requiring flap lysis. This was managed with subflap irrigation, and both patients eventually achieved a best-corrected visual acuity of 5.0.
Conclusion/Take home message
In patients with grade 3 or higher DLK, timely subflap irrigation combined with hormonal shock therapy has a positive impact on the recovery of the patient's visual acuity as well as corneal morphology in the postoperative period.