ABSTRACT
PURPOSE: To report a case of diffuse lamellar keratitis (DLK) associated with acute anterior uveitis that occurred 3 years after uneventful LASIK in a patient with a history of ankylosing spondylitis and recurrent acute anterior uveitis. METHODS: A 36-year-old man presented with pain and decreased vision in the left eye. Left eye visual acuity was 20/100. He had undergone bilateral LASIK 3 years prior to presentation to treat moderate myopia. RESULTS: Slit-lamp examination revealed aqueous flare and cells, vertical corneal folds, and cell aggregates at the central interface. Flattening and thinning of the cornea were observed with Pentacam (Oculus Optikgeräte GmbH). Diffuse lamellar keratitis stage III was diagnosed and intensive corticosteroid and anticollagenolytic treatment was started with satisfactory results. CONCLUSIONS: Acute anterior uveitis may be a predisposing factor for late-onset DLK after LASIK surgery. Indication of LASIK in patients at high risk of developing recurrent flares of acute anterior uveitis, such as those with spondyloarthropathies, should be carefully considered.
Subject(s)
Keratitis/etiology , Keratomileusis, Laser In Situ/adverse effects , Spondylitis, Ankylosing/complications , Uveitis, Anterior/etiology , Adult , Corneal Topography , Glucocorticoids/therapeutic use , Humans , Keratitis/diagnosis , Keratitis/drug therapy , Male , Myopia/complications , Myopia/surgery , Recurrence , Risk Factors , Uveitis, Anterior/diagnosis , Uveitis, Anterior/drug therapy , Visual AcuityABSTRACT
We assessed and compared the retinal nerve fiber layer (RNFL) thickness in normal eyes, ocular hypertensives, preperimetric glaucoma and glaucomatous subjects by means of optical coherence tomography in 449 eye. RNFL in glaucoma patients was significantly thinner than in normal subjects in every location evaluated. Use of optical coherence tomography detects glaucomatous RNFL losses in preperimetric glaucoma and can improve our ability to detect structural damage in clinical practice.
