Posters

Grade 4 diffuse lamellar keratitis (Sands of Sahara syndrome) after FemtoLASIK

Poster Details

First Author: A.Balestrazzi ITALY

Co Author(s):    E. Balestrazzi   P. Michieletto   A. Balestrazzi              

Abstract Details

Purpose:

Describe a case of this complication, the characteristics at the time of diagnosis and the clinical progression

Setting:

Balestrazzi Eye Center Rome

Methods:

A 25 year-old man first came in February 2017 for the correction of his refractive error. Best corrected visual acuity (BCVA) was 20/20 in both eyes with – 1.50-0.50 X 180 in the right eye and– 1.75-0.25 X 180 in the left eye . Uneventful femtolasik was performed the same day in both eyes with iFS® FEMTOSECOND LASER150 kHz. Laser treatment was completed with Bausch & Lomb excimer laser. The following day UCVA was 20/25 in the right eye and 20/20 in the left eye, at the slit lamp examination a diffuse fine whitish granular cell reaction was noticeable.

Results:

The patient started desamethasone and lubricating eyedrops . On day five slit lamp biomicroscopy revealed in both eyes an appearance similar to a scar more dense in optical zone and striae convergent towards the infiltrate, visual acuity decreased at 20/32. We started treatment with hyperosmolar ophthalmological solution, oral doxycycline , topical 10% sodium citrate,desamethasone and lubricating eyedrops . After two week UCVA was 20/32,after one month UCVA was 20/80 in both eyes, at three months UCVA was more than 20/25 in the both eyes . At six months UCVA was 20/20 in both eyes and corneal topography was more regular.

Conclusions:

Non Specific Diffuse Intralamellar Keratitis is a rare complication of femtolasik , its origins are unclear, probably is a sterile inflammation of the interface. Early signs are evident on the first postoperative day , but in some cases from day 3 to 5 white opaque areas are noticeable in the interface with a reduction in visual acuity. To our knowledge, there are only few reports of DLK caused by femtosecond lasers and only few case reports of stage 3 and 4 . In our opinion ,with appropriate diagnosis and treatment, final visual outcomes are almost comparable to cases with uneventful postoperative courses

Financial Disclosure:

None