RESUMO
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 10th,2016 to February 22th,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.
RESUMO
AIM:To investigate the safety and complications of femtosecond laser corneal small incision lenticule extraction(SMILE) procedure and discuss the prevention and treatment.METHODS: We retrospectively studied the complications of 403 patients(799 eyes) with myopia and myopic astigmatism treated by SMILE.RESULTS: All the patients underwent the operation successfully.Only 1 case(1 eye)suffered from dark spot and changed to femtosecond laser-assisted LASIK(FS-LASIK), 5 cases(5 eyes, 0.6%) suffered from the suction loss, 11 cases (17 eyes, 2.1%) developed opaque bubble layer.All patients gained perfect uncorrected visual acuity(UCVA) (20/20).The best corrected visual acuity(BCVA) did not decrease after operations.The incidence of haze and diffuse lamellar keratitis was low (0.3% and 0.4%, respectively)and no other complications were observed.There was 9 eyes in 6 patients (1.1%) found regression of refraction at 6mo after surgery, while the UCVA of rest patients reached 1.0 at 3mo after surgery.CONCLUSION: The SMILE procedure has high safety for myopia and myopic astigmatism.Effective prevention and management of the complications is the key to achieve the satisfactory visual acuity.