Risk factors for diffuse lamellar keratitis following LASIK: a retrospective large database analysis

Session Details

Session Title: LASIK II

Session Date/Time: Tuesday 25/09/2018 | 16:30-18:00

Paper Time: 17:38

Venue: Room A3, Podium 2

First Author: : F.Segev ISRAEL

Co Author(s): :    M. Mimouni   T. Sela   G. Munzer   I. Kaiserman           

Abstract Details

Purpose:

In corneal refractive surgery, there are several intraoperative and postoperative complications that are unique to Laser-assisted in situ keratomileusis (LASIK), most of which are related to the corneal flap. Postoperative complications include dislocated flaps, striae and folds, epithelial ingrowth, infectious keratitis and diffuse lamellar keratitis (DLK). DLK is one of the more potentially devastating complications which in its more advanced stages include flap melting. We aimed to determine factors associated with sporadic DLK following LASIK.

Setting:

Care-Vision Laser Centers, Tel-Aviv, Israel

Methods:

This large database study included consecutive cases of LASIK performed between 2007 and 2016. Patients were divided into 2 groups according to whether or not they subsequently developed DLK. A total of 24,026 eyes of 12,013 patients with a mean age 32.9 ± 10.3 years were included. Post-LASIK DLK developed in 464 eyes (1.9%) and the annual rate decreased from 7.1% (2007) to 1.7% (2016) (p<0.001).

Results:

DLK group had significantly higher proportion of males, greater preoperative central corneal thickness, and lower proportion of high astigmatism (0.4% versus 1.6%, p=0.05). DLK group had higher proportion of prior LASIK treatment (2.8% versus 1.3%, p=0.006), Moria M2 (rather than SBK) microkeratome (71.1% versus 34.0%, p<0.001), smaller suction ring number (p<0.001), greater stop size (p<0.001) and greater flap thickness (119.2±50.4 versus 110.8±22.2, p=0.007). Smaller suction ring number (OR=0.89, p=0.04), Moria M2 microkeratome (OR=5.26, p<0.001), larger optic zone (OR=2.04, p=0.01) and higher spherical equivalent (OR=1.08, p=0.02) were associated with DLK.

Conclusions:

In the modern LASIK era the incidence of DLK continues to decrease. Higher preoperative ametropia, smaller suction ring number, an older type of microkeratome and larger optic zones are associated with higher DLK rates following LASIK.

Financial Disclosure:

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