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Surgical markers linked to DLK outbreak
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CHICAGO — An outbreak of diffuse lamellar keratitis after LASIK at the Singapore National Eye Center was observationally linked to the use of surgical markers, according to a presenter here.
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After eight cases of diffuse lamellar keratitis (DLK) were noted on the same day — July 24, 2007 — physicians reviewed 125 eyes of 115 patients that underwent myopic LASIK between July 23 and July 26. That review included a look at the products used during the LASIK procedures.
"At [Singapore National Eye Center], there are strict protocols on the introduction of new equipment and consumables, and that includes new batches of consumables of all LASIK procedures," Wei-Han Chua, FRCSEd, FAMS, said at the American Society of Cataract and Refractive Surgery meeting. "We were able to record every change that we did to the usual regimen. The only change that was made to protocol was the introduction of a new batch of surgical markers."
Dr. Chua said a new batch of Codman surgical marker pens (Johnson & Johnson) were used at that time. After the DLK outbreak, surgeons discontinued using that batch of Codman pens to mark the cornea, and the incidence of DLK went back to zero.
The surgeons notified Johnson & Johnson Medical of the outbreak, and the company responded that the pens were intended to mark intact skin only, Dr. Chua said.