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Delayed Diffuse Lamellar Keratitis after Laser in Situ Keratomileusis
並列摘要
To report a case of delayed onset of diffuse lamellar keratitis associated with epithelial defect after laser in situ keratomileusis. A 44-year-old female presented with an epithelial defect in her left eye 4 weeks after laser in situ keratomileusis for myopia and astigmatism. She was treated with topical antibiotics and bandage contact lens initially. Unfortunately, she complained of worsening pain and decreased vision. Examination was remarkable for an uncorrected visual acuity of 20/200 on left eye. Slitlamp biomicroscopy showed a focal 1.5 x 2.5 mm epithelial defect with a surrounding white multiple granular infiltrates confined to the interface. The lamellar flap was lifted and debrided of soft infiltrate. The interface was irrigated with balanced saline solution, then, the flap was repositioned, and the bandage soft contact lens and lower punctual plug were placed in her left eye. Stains and cultures revealed no organisms. Topical prednisolone acetate was given every 2 hours and combined with frequent lubrication. Follow-up examination 48 hours later showed improved visual acuity to be 20/50 on left eye with completely healed epithelial defect. The interface keratitis resolved completely. The best-corrected visual acuity was 20/30 on left eye on 1-month later.