Published online May 6, 2022. doi: 10.12998/wjcc.v10.i13.4131
Peer-review started: April 18, 2021
First decision: September 28, 2021
Revised: October 9, 2021
Accepted: April 8, 2022
Article in press: April 8, 2022
Published online: May 6, 2022
Diffuse lamellar keratitis (DLK) is a complication of laser-assisted in situ keratomileusis (LASIK). This condition can also develop after small-incision lenticule extraction (SMILE) with a distinctive appearance. We report the case involving a female patient with delayed onset DLK accompanied by immunoglobulin A (IgA) nephropathy.
A 22-year-old woman was referred to our department for DLK and a decline in vision 1 mo after undergoing SMILE. The initial examination showed grade 2 DLK in the flap involving the central visual axis of the right eye. She was immediately administered with a large dose of a topical steroid for 30 d. However, the treatment was ineffective. Her vision deteriorated from 10/20 to 6/20, and DLK gradually worsened from grade 2 to 4. Eventually, interface washout was performed, after which her vision improved. DLK completely disappeared 2 mo after washout. Six months after SMILE, the patient was diagnosed with IgA nephropathy due to a 4-year history of interstitial hematuria.
DLK is a typical complication of LASIK but can also develop after SMILE. Topical steroid therapy was ineffective in our patient, and interface washout was required. IgA nephropathy could be one of the factors contributing to the development of delayed DLK after SMILE.
Core Tip: Diffuse lamellar keratitis (DLK) is a typical complication of laser-assisted in situ keratomileusis but could also develop after small-incision lenticule extraction (SMILE). Topical steroid therapy was ineffective in our patient, and interface washout was required. Immunoglobulin A nephropathy could be one of the factors contributing to the development of delayed DLK after SMILE.