Purpose: To report the impact on visual function and corneal aberrations during an epidemic of diffuse lamellar keratitis (DLK).
Methods: A retrospective, comparative, and consecutive case-control study was performed, involving 418 eyes operated between March and October 2007 in the refractive surgery unit of one center. Eyes were separated into groups: group 1 (DLK group) included 209 eyes that presented with DLK after LASIK and group 2 (control group) included 209 unaffected, consecutive eyes operated from the beginning of the outbreak. Refractive variables and corneal aberrations were compared between the two groups.
Results: Visual outcomes were significantly different when comparing control eyes and eyes with DLK grades 3 and 4, but not for eyes with DLK grades 1 and 2. Uncorrected distance visual acuity (UDVA) significantly improved from the third month after DLK was diagnosed (Kruskal-Wallis, P=.02). Corrected distance visual acuity (CDVA) did not decrease significantly with DLK grades 1 and 2 (preoperative CDVA vs 1, 3, and 6 months after diagnosis; Mann-Whitney, P>.05, respectively). At the end of follow-up, UDVA and CDVA were not significantly different between the two groups. Eyes suffering from DLK had significantly increased corneal aberrations, except for spherical and astigmatism aberrations, 3 months after being diagnosed (Kruskal-Wallis, P<.05); however, corneal aberrations were not significantly different between the DLK and control groups (Mann-Whitney, P>.05).
Conclusions: The outbreak of DLK did not induce a significant decrease in global visual outcomes, except in severe cases, and postoperative corneal aberrations were not affected.
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