What is a treatment for Stage 3 diffuse lamellar keratitis?
Given its inflammatory nature, all stages of DLK typically respond well to corticosteroid therapy. In certain cases irrigation beneath the flap followed by flap repositioning can remove subepithelial infiltrates and minimize complications associated with the condition.
What is the major factor implicated in DLK?
Risk factors DLK is predominantly associated with Lasik, as the creation of a flap creates a potential space for cells to accumulate. Individuals with atopic conditions with pre-existing allergic conjunctivitis, or ocular rosacea, are more prone to developing the condition after surgery.
What causes DLK after Lasik?
Diffuse lamellar keratitis (DLK) is a relatively infrequent complication of LASIK [1]. It may occur after any surgical procedure in which a corneal lamellar incision has created an interface through the stromal tissue.
What is Nummular keratitis?
Nummular keratitis is a feature of viral keratoconjunctivitis. It is a common feature of adenoviral keratoconjunctivitis (an ocular adenovirus infection), as well as approximately 1/3rd of cases of Herpes Zoster Ophthalmicus infections. It represents the presence of anterior stromal infiltrates.
What is anterior lamellar keratoplasty?
Deep anterior lamellar keratoplasty (DALK) is a surgical procedure for removing the corneal stroma down to Descemet’s membrane. It is most useful for the treatment of corneal disease in the setting of a normally functioning endothelium.
How much does a corneal transplant cost in India?
Now, the cost of corneal transplant surgery ranges between Rs 50,000 and Rs 1 lakh, and is done at private sector hospitals only. With the launch of the eye bank, the health department will make corneal transplant facility available to poor patients free of cost.
What is DLK after Lasik?
Diffuse lamellar keratitis (DLK) results in the accumulation of inflammatory cells in the interface between the LASIK flap and corneal stroma, and can be one of the most serious complications of LASIK if not treated quickly and properly.
What are the names of Diffuse lamellar keratitis?
Diffuse lamellar keratitis (DLK) is referred to by several names, including Sands of Sahara, Sands, nonspecific diffuse interface keratitis, and LASIK interface keratitis (LIK). DLK and Sands are the most common terms.
What happens in Stage 4 lamellar keratitis?
Stage 4 is the rare result of a severe lamellar keratitis with stromal melting, permanent scarring, and associated visual morbidity (Figure 6). The aggregation of inflammatory cells and release of collagenase results in fluid collection in the central lamellae, with overlying bullae formation and stromal volume loss.
When was the first report of lamellar keratitis?
The first anecdotal reports of a mysterious post-LASIK inflammatory syndrome appeared in the late 1990s, along with the rise in the procedure’s popularity. The first published report, by Smith and Maloney, 1 appeared in March 1998. It described a peculiar noninfectious inflammatory reaction occurring in the lamellar interface shortly after LASIK.
Is there a contaminant in the LASIK interface?
Anecdotal reports of case clusters suggest a contaminant in the lamellar interface introduced at the time of surgery. Indeed, Kaufman and coauthors 2, 3 have used scanning, confocal, and electron microscopy along with liquid chromatography to document the presence of oil, wax, metallic, and other foreign particles in the LASIK interface.