Posters

Late-onset diffuse lamellar keratitis 15 years after laser in situ keratomileusis

Poster Details

First Author: P. Morales SPAIN

Co Author(s):    A. Camos-Carreras   F. Spencer   P. Diaz   J. Torras           

Abstract Details

Purpose:

To describe late-onset complications of LASIK surgery as late as 15 years postoperatively, emphasizing the importance of long-term follow-up after this surgery.

Setting:

Anterior Segment Department in a tertiary hospital in Spain.

Methods:

Descriptive clinical case, ten month follow-up and imaging examinations.

Results:

We report a case of presumed late-onset Diffuse Lamellar Keratitis (DLK) in the left eye (OS) of a 41-year-old white woman, 15 years after uneventful bilateral Laser In-Situ Keratomileusis. (LASIK). Best Corrected Visual Acuity (BCVA) in the OS at initial presentation was 20/32. Slit-lamp examination revealed a diffuse fine granular haze involving the visual axis. Epithelial defect was observed in the interphase. Early Anterior Segment Optical Coherence Tomography (AS-OCT) demonstrated a diffuse infiltrate in the inferior interphase. Corneal pachymetry was also documented at initial presentation. High-dose topical steroids were prescribed and the patient responded satisfactorily. Follow-up with AS-OCT scans, BCVA measures, refraction and AS photography confirmed resolution of the keratitis after 1-month. BCVA was 20/25 at final follow-up.

Conclusions:

Even though DLK is considered a rare complication in the early post-operative period following LASIK surgery, some cases of late-onset DLK have been described. To date, DLK occurring as late as 15-years after LASIK surgery has not been reported. There are some factors considered as triggers of this pathology, such as infections and epithelial defects, amongst others. In this case an epithelial defect was observed, hence probably being the contributing factor to the development of DLK. Early aggressive treatment of DLK with topical steroids often results in good outcomes and minimal sequelae if diagnosed in a timely fashion.

Financial Disclosure:

NONE