I Dream Of Gardens In The Desert Sand : Case Report Of Severe Dlk Post Lasik
Published 2026 - 44th Congress of the ESCRS
Reference: POREF026 | Type: Case Report | DOI: 10.82333/as0h-1m96
Authors: Dr Mohamed Islem Koutchoukali* 1 , Dr KAMEL HAMOUCHE 2 , Dr Zine elabidine debbache 2 , Dr Mehdi metallaoui 2
1refractive surgery ,clinique Hamouche,Algiers ,Albania, 2refractive surgery ,clinique Hamouche,Algiers ,Algeria
Purpose
Femto LASIK is one of the most commonly performed refractive surgeries. Thanks to new preoperative diagnostic and treatment platforms, complications are becoming increasingly rare. The aim of this case report is to highlight the menagement of one of the rarest complications of LASIK: stage 4 diffuse lamellar keratitis.
Setting
Hamouche Clinic of Ophthalmology , Algiers .
Report of case
24-year-old female patient presents at our refractive center for refractive surgery, She is highly myopic and wears contact lenses; BCVA 20/20 OU
refraction under cycloplegia OD -6.25(-0.25 at 63). OS -6.50(-1.50 at 42)
She was scheduled for Femtosecond-assisted LASIK OU (both eyes at the same day) :
OD: OPTICAL ZONE 7mm, transition zone 1mm, ablation zone 9mm, 90um flap
OS: OPTICAL ZONE 7mm, transition zone 1mm, ablation zone 9mm, 90um flap
Intraoperatively, OU surgery was uneventful.
The patient returned for her post-operative check-up on day 7: very satisfied with her vision in the left eye, but reported blurred vision and photophobia in the right eye.
Examination findings: DLK stage 04 in the right eye, para-central temporal location, flap in place, peripheral cornea clear.
Our therapeutic approach was not to lift the flap, to start topical corticosteroids (dexamethasone) every 3 hours, then gradually reduce the dosage (with strict IOP control) + oral doxycycline.
Follow-up was based on biomicroscopic, topographic, and tomographic monitoring.
At one-month and three-month postoperative follow-up, the patient reported improved vision, reduction in lesion size, minimal stromal thinning , and a hypermetropic shift.
Conclusion/Take home message
The overall incidence of DLK remains low, and the majority of cases are treated effectively without long-term sequelae.
This case highlights a typical presentation of unilateral stage 04 DLK ( even though both eyes underwent surgery at the same day) , medical treatment was initiated and lifting/irrigation of the flap was not necessary.
Vigilance is required, particularly in the early postoperative period, to detect and treat DLK.