Late-onset diffuse lamellar keratitis

Photorefractive keratectomy for refractory laser in situ keratomileusis flap striae

Photorefractive keratectomy (PRK) with mitomycin-C (MMC) was performed in 2 patients with visually significant, complicated laser in situ keratomileusis flap striae. These striae had been resistant to multiple treatments, including stretching, suturing, and PRK. The visual symptoms in both patients resolved after PRK with MMC, and both patients were stable 1 year later. Wavefront-guided PRK with MMC may be a viable treatment for patients who have complicated flap striae resistant to standard measures.

The effect of diffuse lamellar keratitis on visual acuity and contrast sensitivity following LASIK

Purpose

To evaluate visual outcome and the changes of contrast sensitivity (CS) after diffuse lamellar keratitis (DLK).

Methods

Using retrospective chart review, 48 eyes of 25 patients who underwent laser in situ keratomileusis (LASIK) with Visx S4 (VISX Inc., Santa Clara, CA) and M2 (Moria, France) and who were followed for at least six months were included. They were divided into two groups: DLK and non-DLK, by diagnosis of DLK or its absence after LASIK. Postoperative logMAR visual acuities and logCS measured using the VCTS® 6500 (Vistech Consultants, Inc., Dayton, OH) were compared with preoperative values in the DLK and non-DLK groups at three and six months after LASIK.

Results

There was no difference in logMAR visual acuity between the DLK and non-DLK groups until the sixth postoperative month. However, CS was significantly decreased at 12 and 18 cycle/degree compared with preoperative values (p=0.043 and p=0.045, respectively) in the DLK group, whereas CS was significantly increased at 12 cycle/degree in the non-DLK group (p=0.042) at six months.

Conclusions

DLK seemed to be strongly associated with a postoperative decrease of CS.

A Standardized Drawing Scheme to Document Corneal Changes Following Refractive Corneal Surgery

PURPOSE

To present a systematic and standardized drawing scheme for unambiguous and reproducible documentation of corneal changes after incisional techniques, coagulative procedures, and lamellar and surface ablation excimer surgery.

METHODS

Standardized symbols in five colors representing specific corneal conditions after incisional surgery (eg, radial keratotomy, astigmatic keratotomy), coagulative procedures (eg, laser thermokeratoplasty, conductive keratoplasty), surface ablation (eg, photorefractive keratectomy, laser subepithelial keratomileusis, epi-LASIK), and LASIK are used to record corneal changes in frontal and sectional views.

RESULTS

Corneal changes following refractive corneal surgery were documented.

CONCLUSIONS

The drawing scheme permits specific features to be followed in the clinic in a clear and unambiguous manner.