Complications & Risks Of LASIK - Diffuse Lamellar Keratitis (DLK)

Diffuse Lamellar Keratitis (DLK) is one of the most common complications of LASIK. The DLK's nickname is Sands of the Sahara and reported incidence ranges from 0.7% - 32%.

DLK, if it is to present, is almost always seen on the first day after LASIK surgery, It is characterized by a diffuse white, granular infiltrate occurring within a few days. Patients report decreased vision, photophobia, decreased pain, and foreign body sensation.

Complications & Risks Of LASIK - Diffuse Lamellar Keratitis (DLK)

There Are Four Stages Of DLK :

Stage 1 : The Central Cornea Is Not Affected

Generally appears shortly after LASIK and consists of the presence of foreign matter in the periphery of the corneal flap.

Stage 2 : Foreign Material Migrates To Visual Axis Central

This stage occurs a few days after the condition starts developing. As dense clumps of cells collect on your central visual axis, the disorder begins transitioning into stage 3.


Stage 3 : Experience A 1 Or 2 Line Loss Of Visual Acuity

Your eyes may begin to develop permanent scarring if they are not treated.

Stage 4 : Central Tissue Loss May Lead To The Development Of Hyperopia In Your Vision

The condition has become very severe. Patients often experience stromal melting and permanent scarring. It is rare that DLK progresses to this stage without treatment.

Reasons Of DLK After LASIK

The etiology of DLK is still a mystery. The exact cause of this noninfectious condition is still unknown. Proposed causes of DLK include deposits from microkeratome blades, particles from the eye drape, epithelial defects, meibomian secretions, surgical glove talc, debris from surgical sponges, and contamination of reservoir sterilizers by gram-negative endotoxins.


Treatment is normally topical and oral medication such as antibiotics and topical steroids. Generally consists of anti-inflammatory eye drops that must be used frequently for several months. Sometimes it is necessary to lift the flap, remove some of the infiltrates, irrigate the area, and reposition the flap. Early diagnosis and prompt treatment is crucial to preventing permanent vision loss.