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Chapter-21 Chang's LASIK Complications

BOOK TITLE: Lasik and Lasik Complications

Author
1. Chang JS
ISBN
9788184482324
DOI
10.5005/jp/books/10443_21
Edition
1/e
Publishing Year
2008
Pages
6
Author Affiliations
1. Chinese University of Hong Kong
Chapter keywords

Abstract

DLK, also known as Sands of Sahara is a sterile inflammation in the interface without microbial cause. The appearance of signs and symptoms may emerge within twenty-four hours to a few days after initial surgery. Stage 1 or 2 (granular cells in the periphery) therapy is topical steroid drops every hour and topical steroid ointment at night. Close monitoring is required to prevent it from progressing to stage 3 (central migration of the cells). Flap lifting and irrigation of the bed underside of the cap is required once stage 3 is identified. Epithelial ingrowth can occur after LASIK surgery particularly when there is loose epithelium or an epithelial defect that occurs at the flap margin. The epithelium normally takes the path of least resistance and therefore often grows under the flap. Placing a bandage contact lens over the cornea is the best method to avoid any ingrowth. It allows the epithelium to follow the contact lens and grow over the incision gap rather than grow into it. With keratome LASIK the epithelial ingrowth is usually in the periphery. Unless it grows into the center it often does not affect vision and can be left alone. If it is in the center and affecting the patients’ refraction or vision, it will need to be removed. Topical steroid is used for a few days as some of the patients showed some anterior chamber cells and flare after the clean up procedure.

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