Treat atopy to reduce risk of DLK, study suggests

MADISON, Wisc. — Patients with atopy should use prescription allergy medication before LASIK surgery to help prevent diffuse lamellar keratitis, a study here suggests.

The retrospective study by Stephen M. Boorstein, MD, and colleagues found that atopy is a patient-specific risk factor for the development of DLK after LASIK for myopia or myopic astigmatism. However, the study also found that the risk of DLK in atopic patients who were using an oral histamine blocker did not differ significantly from that in nonatopic patients.

Dr. Boorstein and colleagues retrospectively studied 360 patients who underwent same-day bilateral myopic astigmatic LASIK over a 4-month period. Patients preoperatively identified whether they were atopic and whether or not they were taking allergy medication. Of the 360 patients, 94 were atopic. Of those 94, 26 used a prescription allergy medication (loratadine or fexofenadine).

The risk of DLK among untreated atopic patients was much greater than the risk of DLK among nonatopic patients (P = .001). An untreated atopic patient was five times more likely than a nonatopic patient to exhibit DLK. The risks of DLK among atopic patients taking allergy medications and among nonatopic patients did not differ significantly.

The study authors plan on conducting a randomized, double-blind study for atopic patients’ use of allergy medication before LASIK.

Their current study is published in the January issue of Ophthalmology.