| Diffuse Lamellar Keratitis after Trabeculectomy in a Patient with Laser in situ Keratomileusis. |
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Ji Hyoung Chey, Seung Hwan Jo, Chang Kyu Lee |
1Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea.
2Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. coolleo@uuh.ulsan.kr |
| 레이저각막절삭성형술을 시행받은 환자에서 섬유주절제술 후 발생한 미만층판각막염 |
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최지형1⋅조승환1⋅이창규2 |
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메리놀병원 안과1, 울산대학교 의과대학 울산대학교병원 안과학교실2 |
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| Abstract |
PURPOSE
In the present study, a case of diffuse lamellar keratitis after trabeculectomy in a patient who had received laser in situ keratomileusis many years prior is reported. CASE SUMMARY: A 54-year-old male diagnosed with binocular primary open-angle glaucoma underwent trabeculectomy in the left eye because of poor intraocular pressure control and visual field defect progression even with maximal medical treatments. Faint, non-progressing subepithelial opacities pre-existed in the left cornea but no treatment was administered. The patient had a history of laser in situ keratomileusis in both eyes 12 years prior. On the first postoperative day, conjunctival buttonhole was found and because leaking from the hole continued, topical steroid was discontinued on the fourth postoperative day. On the seventh postoperative day, diffuse lamellar keratitis developed on the central cornea without intraocular pressure elevation, and diffuse infiltration under the corneal flap was observed in the anterior segment on optical coherence tomography. The patient was treated with topical steroid eye drops every 3 hours for the first 2 days and the frequency was increased to every hour because the keratitis did not improve. On the ninth postoperative day, keratitis began to improve and 2 months postoperatively, subepithelial lamellar infiltration improved significantly but did not show complete remission. CONCLUSIONS: Diffuse lamellar keratitis can develop in an eye with laser in situ keratomileusis after trabeculectomy if appropriate treatment with topical steroid eye drops is not administered. |
| Key Words:
Diffuse lamellar keratitis;Laser in situ keratomileusis;Trabeculectomy |
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