Early (< 3 Months) and Late (> 3 Months) Complications of LASIK
This chapter focuses on early postoperative LASIK complications such as sterile inflammation (e.g. diffuse lamellar keratitis, DLK), infectious keratitis, epithelial or flap folds, epithelial ingrowth (EIG) and dry eye. By definition early postoperative c
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Early ( 3 Months) Complications of LASIK Stephan J. Linke, Fernando Llovet, Julio Ortega-Usobiaga, Andrea Llovet, Julio Baviera, Mercedes Martínez-del-Pozo, Gonzalo Muñoz, Cesar Albarrán, and Toam R. Katz
Early Postoperative Complications (< 3 Months) Stephan J. Linke This chapter focuses on early postoperative LASIK complications such as sterile inflammation (e.g. diffuse lamellar keratitis, DLK), infectious keratitis, epithelial or flap folds, epithelial ingrowth (EIG) and dry eye. By definition early postoperative S.J. Linke, MD, PhD (*) Department of Ophthalmology, University Medical Center Hamburg Eppendorf, Martinistr. 52, 20246 Hamburg, Germany zentrumsehstärke, Martinistr. 64, 20251 Hamburg, Germany CareVision GmbH, Martinistr. 52, 20246 Hamburg, Germany e-mail: [email protected] F. Llovet, MD, PhD (*) • M. Martínez-del-Pozo, MD Department of Refractive and Cataract Surgery, Clínica Baviera, Madrid, Spain e-mail: [email protected] J. Ortega-Usobiaga, MD, PhD Department of Refractive and Cataract Surgery, Clínica Baviera, Bilbao, Spain A. Llovet, MD Ophthalmology, Centro de Oftalmología Barraquer, Barcelona, Spain J. Baviera, MD Department of Refractive and Cataract Surgery, Care-Vision, Frankfurt, Germany G. Muñoz, MD, PhD • C. Albarrán, OD Department of Refractive and Cataract Surgery, Clínica Baviera, Castellón, Spain T.R. Katz, MD, PhD Department of Ophthalmology, University Medical Center Hamburg Eppendorf, Hamburg, Germany CARE Vision Germany GmbH, Frankfurt/Main, Germany e-mail: [email protected] © Springer International Publishing Switzerland 2016 S.J. Linke, T. Katz (eds.), Complications in Corneal Laser Surgery, DOI 10.1007/978-3-319-41496-6_9
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Table 9.1 Overview on early postoperative LASIK complications Complication DLK
Incidence 1–2 %
Time of presentation 1st day post operatively
Infectious keratitis Striae
0.03 %
Epithelial ingrowth Dry eye
2 (steroid treatment) Flap lift, culture and irrigation Early flap lift and iron Removal of EIG only if symptomatic or secondary flap melt Recognize risk factors
complication is manifestation within 3 months after the procedure. These early postoperative complications can occur after uneventful surgery and differ significantly in their clinical impact on the postoperative outcome and are therefor introduced separately. A number of postoperative complications can be avoided or minimized by careful intraoperative management. Focused attention should be paid to infectious keratitis which must be clearly separated from non infectious (diffuse lamellar) keratitis. Especially infectious keratitis can result in severe visual loss if not adequately addressed. The possible complications are listed in the order of their usual time line and summarized in Table 9.1.
Non Infectious: Diffuse Lamellar Keratitis (DLK) Incidence and Symptoms Diffuse lamellar keratitis (DLK) is a rare, multifactorial but unspecific immunological reaction with infiltration of white blood cells between the flap and the stromal cornea following surgical
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