Clinical study of the clusters of diffuse lamellar keratitis after laser corneal refractive surgery

AIM: To investigate the potential causes and management of the clusters of diffuse lamellar keratitis(DLK)after laser corneal refractive surgery. METHODS: The study enrolled 98 eyes(53 patients)complicated with DLK after receiving laser in situ keratomileusis(LASIK), FS-LASIK or small-incision lenticule extraction(SMILE)in our center from February 10^th,2016 to February 22^th,2016. They were given clinical classification treatments according to corneal layer inflammatory extent and then followed up after 1, 3, 5, 7, 10d and 1mo. RESULTS: The clusters of DLK occurred 5 times in the study period. The incidence and degree of DLK significantly decreased after changed the sterilization, surgical equipments, temperature and humidity of the operating room. There were 80 eyes(82%)had stage 1 DLK, 11 eyes(11%)had stage 2, 4 eyes(4%)had stage 3 and 3 eyes(3%)had stage 4. The incidence of DLK after FS-LASIK was 40%(79 eyes in 42 patients), that after LASIK assistant by Hastome keratome was 45%(10 eyes in 5 patients), that after SMILE was 20%(9 eyes in 6 patients). After intensive treatment, as glucocorticoid treatment and flap lifting flushing, all cases recovered within 1mo. CONCLUSION: The outbreak of DLK may be associated with the disposable item, flushing liquor, temperature and humidity of the operating room. Early diagnosis, prevention and treatment are the key of decreasing the incidence of DLK.