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Simultaneous, sequential LASIK has no bearing on DLK incidence

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Similar incidence rates of diffuse lamellar keratitis occur regardless of whether the patient undergoes bilateral simultaneous or sequential LASIK, according to a large study.

Stephen D. McLeod, MD, and colleagues with the University of California San Francisco retrospectively reviewed the charts of 1,632 eyes that underwent bilateral simultaneous or sequential LASIK between 1998 and 2001. The inclusion criterion for the study was clinically evident diffuse lamellar keratitis (DLK). If more than one patient developed DLK in a given session, the entire session was excluded. The incidence of unilateral and bilateral isolated, non-epidemic DLK served as the main outcome measure.

Of the eyes, 7.7% developed at least grade 1 DLK. Thirteen of the 107 patients who developed DLK were excluded because more than one patient per session had developed DLK. Of the 94 remaining patients, 16 developed DLK in both eyes. Six patients who developed DLK had simultaneous LASIK and 10 in the sequential group developed bilateral DLK.

The authors reported in the September issue of British Journal of Ophthalmology that the similarity in incidence rates suggests “an underlying intrinsic cause for DLK.”