Diffuse lamellar keratitis and corneal edema associated with viral keratoconjunctivitis 2 years after laser in situ keratomileusis

A 47-year-old woman with a history of laser in situ keratomileusis (LASIK) 2 years previously for myopia and astigmatism, presented with bilateral loss of vision due to diffuse lamellar keratitis (DLK) with corneal edema in the context of a pseudomembranous viral keratoconjunctivitis. After intense and early treatment with topical corticosteroids, the corneal edema and DLK resolved and corneal transparency was achieved with complete restoration of visual acuity. This case shows that DLK may occur associated with a viral pseudomembranous keratoconjunctivitis in patients who have had LASIK. Diffuse lamellar keratitis may present up to 2 years after lamellar surgery, which would indicate that the plane created by the microkeratome at the interface may remain unhealed for at least this period of time. Early diagnosis and treatment with topical corticosteroids can achieve complete resolution without visual loss. © 2004 ASCRS and ESCRS.