Topical Steroids for Prevention of Diffuse Lamellar Keratitis Following LASIK

Purpose: to determine the role of prophylactic topical steroids in the prevention ofdiffuse lamellar keratitis (dlk) after laser in situ keratomileusis (lasik).methods: this randomized double blind clinical trial included consecutive lasikcandidates aged 18 to 55 years with stable (≥1 year) myopia ranging from -2 to -12 diopters.the day before surgery, eyes were randomly allocated to topical betamethasone0.1% or placebo every four hours. one hour preoperatively, the dosage was increased toevery five minutes for at least six times. dlk was graded according to the linebarger-lindstorm classification. patients were examined one week and one and three monthsafter surgery. best-corrected visual acuity (bcva), manifest and cycloplegic refractionand severity of dlk were documented at each visit by a masked examiner.results: overall, 198 eyes (100 in the treatment group and 98 in the control group) of 101patients (97 bilateral and 4 unilateral cases) were operated. pre- and post-lasikrefraction and bcva were comparable in the study groups (p> 0.05). there were nosignificant complications in either group during or after lasik except for dlk whichdeveloped in 55 eyes (55%) of the treatment group including 44 eyes with grade i and 11eyes with grade ii, versus 36 eyes (36.7%) of the control group including 29 eyes withgrade i and 7 eyes with grade ii dlk (p= 0.81).conclusion: although steroids play a key role in the treatment of dlk, pretreatmentwith topical steroids 24 hours prior to lasik does not seem prevent this complication.