DLK scar under a lasik flap (Video)

This eye has had Lasik, and under the corneal flap you can see a small scar. This resulted from DLK (diffuse lamellar keratitis) that can occur when debris at the flap interface causes a non-infectious inflammatory response. This condition is also called the Sands of the Sahara because of the usual wavy appearance of the scar/infiltrate … not seen here.

This scar is small and off the central visual axis, and so did not cause any visual complaints. If the reaction is severe, the flap may need to be lifted and irrigated to remove the material.

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dlkscarlasik.wmv (5.8 meg, Windows video file)

Screencaptures

DLK cornea — This image shows a paracentral scar that likely occured from DLK (diffuse lamellar keratitis) after lasik surgery. DLK is believed to occur from localized inflammatory reaction to microscopic debris under the corneal flap.

DLK scar — This particular scar doesn’t look much like the “Sands of the Saharra” scar you hear about, but occured by the same process … inflammation at the corneal flap interface.

DLK lasik scar — The lesion is at the level of the flap, which you can kind of tell from how the slit-lamp beam hits the cornea.

4 Comments

Umm..that looks pretty scary, can it be fixed? Thankfully I had the surgery without any problems, but seeing something like this would give anyone second thoughts.

How can you distinguish between the flap interface and epithelium?

With the slit beam. The epithelium is right at the top (measures about 50 microns) and the LASIK flap is deeper (measures about 100-110 microns thatwhy goes deeper – means to the stroma of the cornea).

Hi, I got similar case in my left eye after lazik last week.
It is central in location. So how should this condition treated? The doctor advise to leave it until stabilized then curtage it after 1 month.

thanks

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Screencaptures

4 Comments

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