Central necrotic lamellar inflammation after laser in situ keratomileusis.

PURPOSE To report four cases of corneal interface complications that occurred after excimer laser in situ keratomileusis (LASIK). METHODS Four eyes of three patients underwent technically uneventful LASIK. RESULTS One day after LASIK, patients presented with severe pain, blurred vision, conjunctival infection, and diffuse opacity at the interface. Two days after LASIK, significant features were central opacity, striae in the flap, loss of uncorrected and best spectacle-corrected visual acuity, and corneal sensitivity. The findings did not improve by using drugs or by lifting the flap and irrigating the bed. The central opacity partially resolved over 8 to 12 months, leaving a hyperopic shift (one patient), striae (one patient), and loss of two or more lines of best spectacle-corrected visual acuity (three patients). CONCLUSION This severe central inflammation after LASIK could be an extreme manifestation of diffuse lamellar keratitis.