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Diffuse lamellar keratitis associated with contact lens after FemtoLASIK: case series

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Session Details

Session Title: Presented Poster Session: Keratorefractive Surgery Results II

Venue: Poster Village: Pod 2

First Author: : N.Duru TURKEY

Co Author(s): :    Z. Duru   D. Ulusoy                    

Abstract Details

Purpose:

The aim of the present study was to present 22 eyes of 11 cases who developed diffuse lamellar keratitis (DLK) due to bandage contact lenses (BCL) containing innofilcon-A material after femto-LASIK surgery.

Setting:

Consecutive series of 11 cases.

Methods:

Topical anaesthesia was achieved with proparacaine (Alcaine®) drops. The flap preparation was performed on the IntraLase FS30 platform (AMO, Inc.), and the laser ablation was performed on Visx Star S4 IR laser (AMO, Inc.). After femto-LASIK, silicone hydrogel BCL with innofilcon-A material (Comfort, Elegance®) was applied to all eyes. Dexamethasone (Maxidex®), moxifloxacin (Vigamox®), and preservative free artificial tears were prescribed, postoperatively.

Results:

On the 1st postoperative day, biomicroscopic examination revealed a yellowish-brown, wavy, and powdery appearance of between the flap and stromal bed in all cases. Stage-1 DLK in 4 eyes, stage-2 DLK in 2 eyes, and stage-3 DLK in 16 eyes were diagnosed in 22 eyes of 11 cases. On the 1st postoperative day, the flap was lifted and the stromal bed was irrigated in 16 eyes with stage-3 DLK, and treated with topical steroid drops such as prednisolone acetate 1%, every hour. Six eyes with stage-1 and stage-2 DLK were treated with only prednisolone acetate 1%, every hour.

Conclusions:

The exact cause of DLK is still unknown. To date, various causes have been proposed. However, contact lens-related DLK has not been reported. We report the first cases of DLK associated with contact lens use with innofilcon-A material. Femto-LASIK is currently the most widely used refractive surgery, so it is important for clinicians to consider contact lens use among the possible causes of DLK.

Financial Disclosure:

None

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