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J Cataract Refract Surg. 2012 Mar;38(3):544-7. doi: 10.1016/j.jcrs.2011.12.017. Epub 2012 Jan 21.

Idiopathic peripheral necrotizing keratitis after femtosecond laser in situ keratomileusis.

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University of Vermont College of Medicine, Burlington, Vermont, USA.


We report a case of necrotizing peripheral keratitis after laser in situ keratomileusis (LASIK) using the low-energy Femto LDV femtosecond laser in a 31-year-old helicopter pilot with no history of medical or ocular disease. The severe peripheral flap inflammation resulted in stromal necrosis that was unresponsive to intensive topical steroid but improved rapidly on oral prednisone. The uncorrected distance visual acuity was maintained at 20/15 in both eyes, and the flaps were left undisturbed rather than attempting a more aggressive intervention such as a flap lift with culture and antibiotic irrigation. Identification of sterile corneal infiltration must be distinguished from infectious etiologies as the treatment is distinctly different. Although increased corneal infiltration has been reported with increasing femtosecond laser energy level for flap creation, to our knowledge this is the first report of necrotizing sterile corneal infiltration after LASIK with the low-energy femtosecond laser.


Neither author has a financial or proprietary interest in any material or method mentioned.

[Indexed for MEDLINE]

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