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Diffuse Lamellar Keratitis Diffuse Lamellar Keratitis (DLK) is referred by several names, including Sands of Sahara, Sands, and Non-specific diffuse interface keratitis. DLK is a post-operative inflammation that occurs in the 24 to 72 hour period after LASIK. This condition is believed to occur in one out of 200-500 cases. Patients with DLK have varying degrees of symptoms that range from asymptomatic to mild discomfort, light sensitivity and a decrease in vision. If left untreated, the DLK may lead into a central inflammation affecting the ability to perceive. Some resulting decrease in visual acuity is represented in a shift to hyperopia or irregular astigmatism. The most common area of DLK is in and around any debris that is left under the flap after the LASIK procedure. Careful examination immediately after the surgery can prevent any debris from being left under the flap, thus decreasing any chances of DLK. Careful examination of the flap edge is extremely important. White cells migrate from the flap edge to the interface just under the flap. In extreme cases of DLK, these cells migrate further to the central area of the interface, thus the decrease of visual acuity. Evidence of past DLK patients has shown that the eye undergoes an allergic reaction sending neutrophils and polymorphonuclecyties to the site. If left untreated, these cells will cause a melting of the flap area and result in irregular astigmatism and decreased visual acuity. DLK should not be confused with superficial punctuate keratitis (SPK). SPK is always on the corneal surface, whereas, DLK is at the level of the interface of the flap. Upon any symptoms described above, the patients should contact Dr. Anderson immediately for the appropriate action. These patients are started on a steroid to decrease the inflammation that is occurring and an antibiotic to guard against any bacterial infection. Treatment is approximately one week to one month, with the appropriate steroid tapering. If there is no response or a minimal one with the medications, then Dr. Anderson will send you back for a flap lift and rinsing. Then the normal post operative period begins again with medications and post-op visits. It is normal with a flap lift that there will be some additional vision fluctuations while the swelling from the procedure diminish. Any aggravated symptoms should be reported to Dr Anderson, and will be dealt with appropriately. DLK is not a common side affect of LASIK, but some laser centers have higher degree of complications than other centers. Dr. Anderson observes the surgery, and performs the immediate post op evaluation for his all patients at the laser center. Any debris is identified and rinsed prior to sending the patient home from the initial surgery. Then the one-day post op is performed in Dr Anderson’s office. As long as there is no indication of any complication from the surgery, the patient is then put on the regular post op evaluation schedule. Primary eye care | Contacts | Glasses | Order contacts online Laser corrective surgery | Keratoconus | Free articles & information Home | Office info | Appointment request form Contact us | Privacy practices Village Optical: In town
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