Interface inflammation after LASIK with low-energy femtosecond laser: a 20,000 eye study

Session Details

Session Title: LASIK: Flap Morphology and Ablation Profile

Session Date/Time: Monday 09/10/2017 | 08:30-10:20

Paper Time: 09:12

Venue: Room 3.6

First Author: : A.Leccisotti ITALY

Co Author(s): :    S. Fields                    

Abstract Details

Purpose:

Diffuse lamellar keratitis (DLK) incidence after femtosecond LASIK is estimated between 8 and 37%. This study assesses the rate and degree of interface inflammatory response after LASIK with flap created by a low-energy femtosecond laser in a large series.

Setting:

Siena Eye Laser, Italy, and University of Siena

Methods:

Retrospective, consecutive, single-surgeon noncomparative case series study of myopic and hyperopic LASIK performed with femtosecond laser Ziemer Z2 and Z4. Interface inflammation was assessed at the slit lamp, Scheimpflug camera and anterior segment OCT in the first 6 months. DLK was graded as follows: stage 1 (peripheral granular cells in the interface), stage 2 (central involvement with granular cells), stage 3 (aggregation of cells involving the center), stage 4 (stromal melt and scarring).

Results:

A total of 20000 eyes of 10223 patients were reviewed. DLK was observed in 186 eyes of 145 patients (0.93% of eyes): stage 1 DLK in 181 eyes of 142 patients, stage 2 in 1 eye, stage 3 (evolved in stage 4) in 2 eyes of a patient, stage 4 in 2 eyes of a patient. All eyes with grade 1 and 2 DLK retained UDVA greater than 0.00 logMAR, whereas eyes with grade 3 and 4 DLK experienced initial stromal thinning and refractive shift, with slow recovery and a final CDVA better than 0.20 logMAR.

Conclusions:

Clinically significant DLK was only observed in 4 eyes of 2 patients (0.02%). With a low energy femtosecond laser, the total incidence of DLK (any stage) after femtosecond LASIK was considerably lower than reported in literature.

Financial Disclosure:

NONE