Bilateral Peripheral Infiltrative Keratitis After LASIK

Laser in situ keratomileusis (LASIK) has been shown to be an effective treatment for myopia, hyperopia, and astigmatism. As with any surgical procedure, complications can arise that threaten best spectacle-corrected visual acuity. When a diffuse infiltrate enclosed in the interface appears within 2 to 6 days postoperatively without anterior chamber reaction or epithelial defect, it can be diagnosed as diffuse lamellar keratitis (DLK). It emanates intermittently or in clumps throughout a broad area.1 Possible etiologies are included oil, wax, metallic fragments, silicates, bacterial endotoxins, epithelial defects, and laser / contaminant interaction, a contaminant in the lamellar interface introduced at the time of surgery. It showed response to topical steroids. Treatment, however, largely rests on the different stages of DLK.1-3 This is a report of multiple round peripheral infiltrate developed following the flap margin and limbus mimicking infectious keratitis on the first day after LASIK.