Diffuse lamella keratitis: diagnosis and treatment methods

Öz

Developing after refractive surgery, Diffuse Lamellar Keratitis is a complication that appears as small gray-white corneal spots in the periphery. It is mostly unilateral (one-eye) and distant to the visual axis. If it goes unnoticed at initial stages, and if appropriate treatment is not applied, it may cause severe visual impairment. Refractive surgery is especially preferred by active and young population to be released of glasses and lens dependence, and is becoming widely applied with each passing day. In this paper, the purpose is to determine the early diagnosis and treatment modalities for Diffuse Lamellar Keratitis, and to examine current approaches for the prevention of permanent visual impairment, which may lead to progressive and irreversible corneal and visual damage.

Anahtar Kelimeler

• Refractive Surgery,Diffus Lamellar Keratit,Permanent Corneal Necrosis,loss of vision

Diffüz lamellar kretatit: Tanı ve tedavi yöntemleri

Öz

Refraktif cerrahi sonrası gelişen diffüz lameller keratit, çoğunlukla unilateral (tek gözde), görme ekseninden uzak, periferal yerleşimli küçük gri-beyaz korneal noktacıklar şeklinde ortaya çıkan bir komplikasyon tablosudur. Başlangıç evrelerde farkına varılmaz ve uygun tedavi ile önlem alınmazsa, ileride ciddi görme kaybına neden olabilmektedir. Özellikle aktif ve genç nüfusun, gözlük ve lens bağımlılığından kurtulmak için tercih ettiği refraktif cerrahi gün geçtikçe daha yoğun bir şekilde uygulanmaktadır. Bu yazıda; ilerleyici ve geri dönüşümsüz kornea ve görme hasarına neden olabilecek, diffüz lameller keratitin, erken tanısı ve tedavisi ile ileride gelişebilecek kalıcı görme kaybının önlenmesi için güncel yaklaşımların ortaya konulması amaçlanmıştır.

Anahtar Kelimeler

• Refraktif Cerrahi,Diffüz Lameller Keratit,Korneanın Kalıcı Nekrozu

Kaynakça

1. 1. Kymionis GD ve ark. Diffuse lamellar keratitis after corneal crosslinking in a patient with post-laser in situ keratomileusis corneal ectasia - Elsevier Journal of Cataract & …, 2007 – 2135-2137
2. 2. Schallhorn SC ve ark, Avoidance, Recognition, and Management of LASIK Complications - Elsevier American journal of …, 2006 - 733-739
3. 3. Stulting RD ve ark, The epidemiology of diffuse lamellar keratitis - Cornea, 2004, - 680-688
4. 4. Steck Rp ve ark, Diffuse lamellar keratitis 14 years after laser in situ keratomileusis induced by an eyelash in the flap interface - Elsevier JCRS Online Case Reports, 2018 – 69-70
5. 5..Dawson DG ve ark, Interface fluid syndrome in human eye bank corneas after LASIK : causes and pathogenesis – Ophtalmology, 2007 – Elsevier - 1848-1859.
6. 6. Iovieno A ve ark, Diffuse lamellar keratitis 8 years after LASIK caused by corneal epithelial defect - Journal of Cataract & …, 2011 - 418-419
7. 7. Reinstein DZ ve ark, Incidence and Outcomes of Sterile Multifocal Inflammatory Keratitis and Diffuse Lamellar Keratitis After SMILE - Journal of Refractive, 2018- 751-759
8. 8. Mimouni M ve ark, , Incidence, Indications, and Outcomes of Eyes Needing Early Flap Lifting After LASIK - Cornea -1118-1123

9. 9. Noda-Tsuruya T ve ark, Risk factors for development of diffuse lamellar keratitis after laser in situ keratomileusis - Journal of refractive, 2004 - 72-75. 10. Castoro CJ, Causes of diffuse lamellar keratitis - Ophthalmology, 2003 - aaojournal.org – 873-874
10. 10. Castoro CJ, Causes of diffuse lamellar keratitis - Ophthalmology, 2003 - aaojournal.org – 873-874
11. 11. Zhao J, Diffuse lamellar keratitis after small-incision lenticule extraction, Journal Cataract refract surg, 2015 – 400-407
12. 12. Shovlin JP, A corneal conundrum: are these post-LASIK complications clinically distinct entities, or a continuum? - Review of Optometry, 2014 - 68
13. 13. Mah FS ve ark, Role of topical fluoroquinolones on the pathogenesis of diffuse lamellar keratitis in experimental in vivo studies - Journal of Cataract & …, 2006 - 264-268.
14. 14, Gritz DC, LASIK interface keratitis: epidemiology, diagnosis and care - Current opinion in ophthalmology, 2011 - 251-255.
15. 15. Alió JL, Azar DT, Management of complications in refractive surgery, 2nd ed, Springer 2018
16. 16 Linebarger EJ ve ark, Diffuse lamellar keratitis: diagnosis and management- Journal of Cataract & …, 2000 – Elsevier- 1072-1077
17. 17. Buxey K, Delayed onset diffuse lamellar keratitis following enhancement LASIK surgery- Clinical and Experimental Optometry, 2004 - 102-106
18. 18.Jeng BH, Relapsing Diffuse Lamellar Keratitis After Laser In Situ KeratomileusisAssociated With Recurrent Erosion Syndrome - Archives of …, 2004- 396-398.
19. 19. Murueta-Goyena Ane, Visual outcomes and management after corneal refractive surgery : A review – Journal of Optometry, 2018 – 121-129
20. 20. Gritz DC, LASIK interface keratitis: epidemiology, diagnosis and care- Current opinion in ophthalmology, 2011 – 251-255
21. 21. Cheung AY ve ark, Late-onset diffuse lamellar keratitis following laser in situ keratomileusis- Canadian Journal of, 2018- 435-437
22. 22. Gris O ve ark, Diffuse lamellar keratitis and corneal edema associated with viral keratoconjunctivitis 2 years after laser in situ keratomileusis - Journal of Cataract & Refractive …, 2004- 1366-1370