Postoperative inflammation, microbial complications, and wound healing following laser in situ keratomileusis

Although the biology of corneal wound healing is only partly understood, he aling after photorefractive keratectomy (PRK) and laser in situ keratomileu sis (LASIK) differs in many respects, and the mechanisms appear to be diffe rently controlled. There is less of an inflammatory and healing response af ter LASIK, but a longer period of sensory denervation. The cellular, molecu lar, and neural regulatory phenomena associated with postoperative inflamma tion and wound healing are likely to be involved in the adverse effects aft er LASIK, such as flap melt, epithelial ingrowth, and regression, Interface opacities in the early postoperative period include diffuse lamellar kerat itis (DLK), microbial keratitis, epithelial cells, and interface opacities. Diffuse lamellar keratitis (sands of the Sahara syndrome) describes an app arently noninfectious diffuse interface inflammation after lamellar corneal surgery probably caused by an. allergic or a toxic inflammatory reaction. Noninfectious keratitis must be distinguished from microbial keratitis to a void aggressive management and treatment with antimicrobial drugs. Microbia l keratitis is a serious complication after LASIK, but a good visual outcom e can be achieved following prompt and appropriate treatment.