Dan TT, Liu TX, Liao YL, Li ZZ. Delayed diffuse lamellar keratitis after small-incision lenticule extraction related to immunoglobulin A nephropathy: A case report. World J Clin Cases 2022; 10(13): 4131-4136 [PMID: 35665110 DOI: 10.12998/wjcc.v10.i13.4131]
Corresponding Author of This Article
Ting-Ting Dan, MD, Attending Doctor, Department of Ophthalmology, The Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Huichuan District, Zunyi 563003, Guizhou Province, China. 231341578@qq.com
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 6, 2022; 10(13): 4131-4136 Published online May 6, 2022. doi: 10.12998/wjcc.v10.i13.4131
Delayed diffuse lamellar keratitis after small-incision lenticule extraction related to immunoglobulin A nephropathy: A case report
Ting-Ting Dan, Tai-Xiang Liu, Yi-Lu Liao, Zong-Ze Li
Ting-Ting Dan, Tai-Xiang Liu, Yi-Lu Liao, Zong-Ze Li, Department of Ophthalmology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
Author contributions: Dan TT, Liu TX, Liao YL and Li ZZ collected the clinical information of the patient, and analyzed and interpreted the clinical data; Dan TT wrote the draft of this manuscript; Liu TX reviewed and edited the manuscript; all authors read and approved the final manuscript.
Supported byNational Natural Science Foundation of China, No. 81660169; and The Education Teaching Reform Project of First Clinical Department of Zunyi Medical College, No. 202009.
Informed consent statement: The patient provided informed written consent prior to the case report.
Conflict-of-interest statement: The authors declare that they have no competing interests to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ting-Ting Dan, MD, Attending Doctor, Department of Ophthalmology, The Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Huichuan District, Zunyi 563003, Guizhou Province, China. 231341578@qq.com
Received: April 18, 2021 Peer-review started: April 18, 2021 First decision: September 28, 2021 Revised: October 9, 2021 Accepted: April 8, 2022 Article in press: April 8, 2022 Published online: May 6, 2022 Processing time: 376 Days and 13.1 Hours
Abstract
BACKGROUND
Diffuse lamellar keratitis (DLK) is a complication of laser-assisted in situ keratomileusis (LASIK). This condition can also develop after small-incision lenticule extraction (SMILE) with a distinctive appearance. We report the case involving a female patient with delayed onset DLK accompanied by immunoglobulin A (IgA) nephropathy.
CASE SUMMARY
A 22-year-old woman was referred to our department for DLK and a decline in vision 1 mo after undergoing SMILE. The initial examination showed grade 2 DLK in the flap involving the central visual axis of the right eye. She was immediately administered with a large dose of a topical steroid for 30 d. However, the treatment was ineffective. Her vision deteriorated from 10/20 to 6/20, and DLK gradually worsened from grade 2 to 4. Eventually, interface washout was performed, after which her vision improved. DLK completely disappeared 2 mo after washout. Six months after SMILE, the patient was diagnosed with IgA nephropathy due to a 4-year history of interstitial hematuria.
CONCLUSION
DLK is a typical complication of LASIK but can also develop after SMILE. Topical steroid therapy was ineffective in our patient, and interface washout was required. IgA nephropathy could be one of the factors contributing to the development of delayed DLK after SMILE.
Core Tip: Diffuse lamellar keratitis (DLK) is a typical complication of laser-assisted in situ keratomileusis but could also develop after small-incision lenticule extraction (SMILE). Topical steroid therapy was ineffective in our patient, and interface washout was required. Immunoglobulin A nephropathy could be one of the factors contributing to the development of delayed DLK after SMILE.
