Interface keratitis or DLK

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Interface keratitis or DLK

Postby Kev6200 » Thu Jan 17, 2008 3:33 am

Just got back from my one week post op check and the first optometrist I saw today (the one who did my refraction and next day check) seemed concerned that I still have significant edema OD. I asked if it was a keratitis and he said that it could be classified as one. My wife did some research and came up with Interface Keratitis or DLK either of which seem to fit all my signs and symptons. I was seen by a second optometrist (for a second opinion) who did not seem as concerned. The first guy even considered reopening the flap to wash out epithelial cells. After consulting with the second optometrist and checking my intraocular pressure (13mmHg OU) it was prescribed that I should decrease the prednisone drops to 4 times QD and follow up in a week. My visual acuity has worsened some in the right eye since just post op and seems to be getting slightly worse by the day.

My wife feels that I should ask to see an ophthalmologist at that practice or go to an outside opthalmologist for a second opinion on severity and treatment. Is this reasonable or can the ODs manage my care? From our research this type of condition is not that common and I want to make sure the treatment regimen prescribed is the best. Any comments? Thanks.

Kevin
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Postby croanster » Thu Jan 17, 2008 8:05 am

Personally, if there was any doubt at all I'd seek an opinion from a opthalmologist. It's probably ok but I'd still check even it's just to put your mind at rest.
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Postby Kev6200 » Sat Jan 19, 2008 2:45 am

Just an update - I did see my ophthalmologist yesterday and he confirmed that I do have DLK. It is bilateral Grade I in each eye. OD he says it is the nasal 1/3, but does not cross the visual axis. OS is almost 360 degree thin line around the perimeter of the flap. I am continuing the prednisone drops QID and will follow up with him next Wed. If it has not improved significantly he will consider reopening the flaps on
Thursday and washing out both sides. I will update after my check if anyone is interested.

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Postby LasikExpert » Sat Jan 19, 2008 6:31 pm

Diffuse Lamellar Keratitis (DLK) commonly causes rapid onset of corneal haze and reduction of vision quality. DLK will commonly cause vision to drop to "count fingers" quality within a few days. It sounds like your situation is different.

Report any sudden changes in vision quality to your ophthalmologist immediately and follow his/her treatment plan religiously. If a flap lift is performed your surgeon probably will send a sample of the cells to a lab to affirm exactly what type of interface problem you have. Other maladies can appear very much like DLK.

Yes, do tell us how you progress.
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Postby Kev6200 » Wed Feb 13, 2008 4:06 am

Just had the "washout" done today OD. It was not a pleasant experience. The office had schedule me on one of the cataract days, because the procedure was done in the OR. They called me yesterday with a 10:15 am appointment for today. All the communication went through my wife, since she did the initial scheduling for the LASIK procedure. My pre-op instructions were not really adequate. The office person my wife spoke with told her that it was a "minor" procedure and that I could drive my self to and from and return to work today. That information turned out to be not so accurate.

I was given 10 mg of valium pre-op, and post-op had considerable light sensitivity and pain (especially after the numbing drops wore off). The procedure itself was not too bad. I was numbed with topical and wheeled into OR and placed under the microscope. The ophtalmologist lifted the flap. He explained that it was like "tearing wet tissue paper". He used saline and a surgical sponge to swab the area. That was an interesting sensation. He irrigated the area and replaced the flap and placed a bandage contact lens until tomorrow's post check. I went back to work, although I probably shouldn't have. I was given a prescription for Vicoden pain and Restiril for sleeping tonight. I have a pretty high pain tolerance, and did not think I would get these filled. I was wrong. Once the numbing drops wore off I had significant pain and did fill and take one of the Vicoden. I took a two hour nap after the med and woke up feeling much better. In retrospect, I should have taken the day off and had someone drive me from the appointment because of the Valium, light sensitivity and pain. I will take the Restiril at least for tonight and see what tomorrow holds.

My vision has been progressing nicely. I was 20/20 near and 20/30 far, but my distant vision is my right eye which had the DLK. I am hoping that at tomorrow's check it will be at least the same or better. I will let you know how it progresses. Thanks for listening.
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