My sister had Lasik surgery about 4 weeks ago and has had very hazy vision since. She was diagnosed with DLK (Diffuse Lamellar Keratitis) which has the common name of 'Sands of Sahara'. The original surgeon, three weeks after the surgery, lifted up the flap on one eye and washed out some white blood cells to try to clear up the problem. So far after one week, there has been no noticeable difference, nor has there been any noticeable improvement in the other eye after 4 weeks post-surgery.

Does anyone have any recommendations on follow-up care that could help to alleviate this problem?

Thanks!

DLK or diffuse lamellar keratitis is an inflammatory condition which is sometimes seen after LASIK. The incidence in my practice was 11/2000 eyes (we only looked at our first 2000 surgeries) So it is not very common, but still occurs. No one knows why it occurs, but it probably has to do with an "antigen" in the tear film of the patient, to which the individual's immune system responds. Most of the time, topical steroid drops are used intensively, and if that is not helping, the flap may need to be lifted to irrigate the white blood cells which are responsible for the inflammation. After this process, once the inflammation has quieted down, the vision may take some time to recover, depending on the way the cornea looks, and depending on its curvature. Sorry, can't give you any specifics without seeing her, but I suggest you have her discuss her condition with her doctor.

I agree with the comments from Dr. Majmudar. Intensive use of topical steriod, even every hour can be helpful especially if it is started early. I have also used "non-steroidal" anti-inflammatory eye drops with the steroid drops every hour and in one patient used oral steroids to get things under control in addition to lifting the flap which is always a smart thing to do. Your doctor will guide you regarding the next step.

Paul,
I agree with both doctors Majmudar and Ofner. Remember that they are explaining what they would do in the situation you have described. However, the use of steroids must be carefully regulated by your treating doctor and you should not initiate any treatment without a thorough discussion. this information is jsut to help you understand the situation and possible treatments.

Best of luck

Bill Trattler, MD
Miami FL

I also have been diagnosed with DLK. Surgury was Friday July 8th.The doctors response the day after surgury was that I had swelling and I should up the drops (Econopred Plus) to every two hours for 2 days. Vision was good but a bit hazy for Saturday and sunday. Monday I noticed more haziness and Tuesday there was a definate drop in vision in my left eye. My next appointment was that afternoon and the response was to up the drops to every hour till today. I have seen no improvement, and probably a decrese in contrast, meaning more starbursts, even during the day. However, the doctor says its is looking better but it is healing from the outside in and I should go down to drops every 2 hours through saturday, then 4 times a day then two times a day. My worry is that I don't have another apptment till next thursday and is very nerveracking seeing no improvement for several days, but gonig down in drops, and no appointment for another week.

Should I be worried? Should I get another opinion on treatment? In my research I found CLK, is that anything to think about?
thanks, Corey