背景：介绍一例有激光原位角膜磨镶术（LASIK）发展为复发性角膜糜烂（RCE）后的弥漫性板层角膜炎（DLK）的病例。
方法：一名25岁男子在飞秒辅助LASIK矫正近视一年后出现多次RCE发作。因为保守治疗未能阻止RCE的反复发作，他接受了上皮清创术和DBSK。然而,术后第一天出现严重异物感和视力模糊。第二天,裂隙灯生物显微镜检查显示DLK在皮瓣界面表现为弥漫性颗粒浸润。局部皮质类固醇治疗后，炎症逐渐消退，他的视力恢复到20/20。
结论：弥漫性板层角膜炎是一种罕见的LASIK术后并发症，可由DBSK引发，这导致角膜上皮完整性的损害和随后的皮瓣界面的炎症。对于LASIK术后RCE患者,替代疗法,如前基质穿刺，根据病变的大小和位置，可以考虑避免角膜上皮和DLK发育的广泛破坏。
BACKGROUND: To present a
case with a history of laser in situ keratomileusis (LASIK) developing diffuse lamellar keratitis (DLK) after diamond burr superficial keratectomy (DBSK) for recurrent corneal erosion (RCE).
METHODS: A 25-year-old man presented with multiple episodes of RCE one year after femtosecond-assisted LASIK for myopia correction. Because conservative treatments failed to halt the repetitive attack of RCE, he underwent epithelial debridement and DBSK. However, severe foreign body sensation and blurred vision developed on postoperative day one. The next day, slit lamp biomicroscopy revealed DLK manifested as diffuse granular infiltrates at the flap interface. After topical corticosteroid treatment, the inflammation resolved gradually, and his vision recovered to 20/20.
CONCLUSIONS: Diffuse lamellar keratitis is a rare post-LASIK complication that can be triggered by DBSK, which causes impairment of the corneal epithelial integrity and subsequent inflammation at the flap interface. For post-LASIK patients with RCE, alternative treatments, such as anterior stromal puncture, may be considered to avoid extensive disruption of corneal epithelium and DLK development depending on the size and the location of the lesions.
