Diffuse Lamellar Keratitis (DLK)

(Also called Sands of the Sahara)

What is DLK? (Posted: apr 2003)

DLK is an accumulation of inflammatory cells in the flap interface. This is most likely to occur within the first several days post-operatively but has been known to happen considerably later. (Click here for LaserMyEye's Encyclopedia entry for DLK.)

How does DLK progress? (posted: apr 2003)

The causes and progression of DLK are not well understood but it is generally thought to occur in four stages:

Stage I: Contaminants or infiltrates in the flap periphery but not the central cornea.

Stage II: Migration of cells into the visual axis.

Stage III: Dense clumps of cells collect in th evisual axis and risk of permanent scarring is greatly increased.

Stage IV: Severe keratitis causing stromal melt and permanent scarring.

What causes DLK and which surgery(-ies) is it associated with? (posted: apr 2003)

DLK is associated exclusively with LASIK. It is not fully known what causes DLK. One known cause is interface debris, including microkeratome debris, dust, cell debris, sponge/Q-tip strands, powder from surgical gloves or other matter fall onto the stromal surface after the ablation.

What are the potential results of DLK? (posted: apr 2003)

It is extremely important that DLK be promptly diagnosed and treated. DLK can lead to haze, scarring, stromal melt, hyperopic shift, irregular astigmatism and permanent loss of BCVA.

How is DLK diagnosed? (posted: apr 2003)

DLK is diagnosed by slit-lamp examination.

Tell-tale symptoms may include pain, blurred vision, foreign body sensation, and sensitivity to light. However, some patients experience no symptoms in the early stages.

How is DLK treated? (posted: apr 2003)

Early identification and treatment are critical. Treatment usually includes topical and sometimes oral medications (steroids, antibiotics). The flap may be lifted and interface wiped if there is believed to be debris.

Where can I get more information about DLK?

Click here for LaserMyEye Encyclopedia entry for DLK, which may have additional articles and links.