RESUMO
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.
Assuntos
Ceratite/etiologia , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Espondilite Anquilosante/complicações , Uveíte Anterior/etiologia , Adulto , Topografia da Córnea , Glucocorticoides/uso terapêutico , Humanos , Ceratite/diagnóstico , Ceratite/tratamento farmacológico , Masculino , Miopia/complicações , Miopia/cirurgia , Recidiva , Fatores de Risco , Uveíte Anterior/diagnóstico , Uveíte Anterior/tratamento farmacológico , Acuidade VisualRESUMO
PURPOSE: To study the effect of autologous serum in the treatment of recurrent corneal erosions. METHODS: Eleven eyes of 11 consecutive patients with acute macroform corneal erosions who had suffered several relapses despite receiving different types of treatment were analyzed from November 2000 to February 2002. All patients were treated with autologous serum for 3 months. RESULTS: Mean follow-up time was 9.4 +/- 3.7 months (range, 4-16). No side effects were noted in any of the treated patients. Treatments prior to the use of autologous serum had failed to avoid recurrences in all the patients, with the mean recurrence rate being 2.2 recurrences per month of follow-up. After the onset of serum treatment, only a single recurrence was recorded in three of the patients (0.028 recurrences per month of follow-up). CONCLUSION: The use of autologous serum for the treatment of patients with recurrent corneal erosion is effective and safe in reducing the number of recurrences experienced by patients.
