Endothelial cell loss associated with diffuse lamellar keratitis because of laser-assisted in situ keratomileusis.

PURPOSE: To report a case of severe interface inflammation, flap edema, and endothelial cell loss after laser-assisted in situ keratomileusis (LASIK). METHODS: A 22-year-old woman with no previous ocular abnormality underwent LASIK for myopia. The surgery was uneventful. Her preoperative endothelial count was 3,066 and 2,898 cells per square millimeter OD and OS, respectively. RESULTS: On the first postoperative day, the right eye had interface infiltrates, flap edema, and radiating Descemet's folds and the left eye had flap edema with interface infiltrates. Bilateral flap relifts and thorough irrigation were performed on the second day, followed by amputation of the nonviable flap in the right eye on the third day. On medical management, the corneal edema resolved for more than 1 month. At 6 months, the best-corrected vision was 20/32 OD and 20/25 OS, with endothelial cell count of 1,763 and 2,055 cells per square millimeter OD and OS, respectively. CONCLUSIONS: Endothelial status should be monitored in patients with a severe interface reaction or severe diffuse lamellar keratitis after LASIK.