Incidence and outcomes of lasik with diffuse lamellar keratitis treated with topical and oral corticosteroids.

PURPOSE To analyze the incidence and clinical outcomes of patients developing diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK) treated with topical and oral corticosteroids. SETTING Oregon Eye Institute, Eugene, Oregon, USA. METHODS A retrospective analysis of the last consecutive 1000 LASIK cases was performed. Eyes developing stage 3 DLK or at risk for progressing to stage 3 were treated with a combination of high-dose prednisolone acetate 1% and oral prednisone and evaluated for corneal scarring, loss of best spectacle-corrected visual acuity (BSCVA), and deviation from the intended refractive outcome. RESULTS Diffuse lamellar keratitis developed in 40 eyes (4%). It progressed to stage 3 in 7 eyes (17%). Oral and topical steroids were used in 22 eyes (55%). The mean variation from the desired refractive outcome was 0.14 diopter +/- 0.53 (SD). There were no instances of corneal scarring or permanent loss of BSCVA. No eye had interface irrigation. CONCLUSIONS Treatment of severe DLK with high-dose topical and oral corticosteroids produced excellent results without flap lifting and interface irrigation.