DLK

Diffuse Lamellar Keratitis (DLK) : is a postoperative complication of Lasik and All-Laser Lasik that occurs when foreign cells (infiltrates) are introduced into the interface between the corneal flap and underlying stroma. DLK can occur with any flap manipulation including initial surgery, enhancement, removal of epithelial ingrowth, etc. There is often pain, blurred vision, foreign body sensation, and sensitivity to light but some patients have no symptoms other than rapid onset of hazy vision. DLK most often is present within one to six days after surgery however DLK has occurred months and years after surgery and can threaten an otherwise successful visual outcome if not properly treated.DLK causes the creation of fine white grainy cells that when viewed through a slit-lamp appear like waves of sand, hence the nickname Sands of Sahara. Although the infiltrates are sterile, the cornea attacks them and if left unchecked will destroy itself causing serious damage and permanent reduction in visual acuity.

DLK is defined in four stages beginning with Stage 1 where DLK is first present through Stage 4 where the cornea is destroying itself.

Stage 1 consists of infiltrates in the periphery of the flap without involvement of the central cornea. This stage most commonly presents on the day after surgery.

Stage 2 occurs as a result of central migration of cells to involve the visual axis. Stage 2 most frequently presents on day two or three. Progression to stage 3 occurs when dense clumps of cells aggregate in the central visual axis. Relative clearance of the periphery is also seen.

Stage 3 usually appears 48 to 72 hours after surgery, and can be associated with a 1- or 2-line loss of visual acuity. Stage 3 has been referred to as "threshold" DLK because many of these eyes will develop permanent scarring if not appropriately treated.

Stage 4 is severe lamellar keratitis resulting in stromal melting and permanent scarring. Central tissue loss causes a hyperopic shift. The incidence of Stage 4 is estimated at one in 5,000 Lasik cases.

Those of you who know me know that I can't do anything the easy way. This is a description of the complication I am currently suffering from after my LASIK surgery last week. I am already at stage 3 and am facing having to have an urgent eye surgery this week to open up the surgical flap and irrigate my eye out with steroids. I have been unable to work these past couple of days and feel like crap. I am hoping that the corneal specialist I am seeing today will have some good news for me.

On the other hand, I am happy to say that the vision in my left eye (the one that was injured ) is perfect. I am seeing better than 20/20 out of it. At least I have one good eye!

Thank you everyone for all of your prayers and support!