Diffuse lamellar keratitis

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Diffuse Lamellar Keratitis

Diffuse Lamellar Keratitis (DLK) is a non-infectious inflammatory condition that can occur after laser-assisted in situ keratomileusis (LASIK) surgery. It is characterized by the presence of white blood cells beneath the corneal flap created during the procedure.

History[edit | edit source]

DLK was first described in the late 1990s as a complication following LASIK surgery. It was initially referred to as "Sands of the Sahara" due to its appearance under the microscope.

Causes[edit | edit source]

The exact cause of DLK is not fully understood, but it is believed to be related to surgical trauma, the presence of foreign substances, or an immune response. Factors such as microkeratome use, laser energy, and environmental contaminants have been implicated.

Symptoms[edit | edit source]

Patients with DLK may experience:

  • Blurred vision
  • Light sensitivity
  • Redness of the eye
  • Discomfort or pain

Diagnosis[edit | edit source]

DLK is diagnosed through a slit-lamp examination, where the characteristic white blood cell infiltrates can be observed beneath the corneal flap. It is important to differentiate DLK from infectious keratitis, which requires different management.

Treatment[edit | edit source]

Treatment of DLK typically involves the use of topical corticosteroids to reduce inflammation. In severe cases, lifting and irrigating the flap may be necessary to remove inflammatory cells. Early detection and treatment are crucial to prevent permanent vision impairment.

Prognosis[edit | edit source]

With prompt treatment, most patients recover fully without long-term effects on vision. However, if left untreated, DLK can lead to scarring and permanent vision loss.

Prevention[edit | edit source]

Preventive measures include meticulous surgical technique, proper sterilization of instruments, and minimizing exposure to potential contaminants during and after surgery.

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Contributors: Prab R. Tumpati, MD