A patient develops diffuse lamellar keratitis (DLK) 3 days after LASIK, with diffuse granular infiltrates at the flap interface in a sand-dune pattern. The initial management is:
- A Intensive topical corticosteroids (prednisolone 1% hourly) ✓
- B Immediate flap lifting and interface irrigation
- C Oral acyclovir
- D Topical antibiotics only
Correct answer: A. Intensive topical corticosteroids (prednisolone 1% hourly)
Explanation
DLK (Sands of Sahara) is a non-infectious inflammatory response to the lamellar interface, typically treated with intensive topical corticosteroids (prednisolone 1% every 1-2 hours). Stage 1 and 2 DLK respond well to this approach. Flap lifting is reserved for stage 3-4 with risk of flap melt or visual loss. Antibiotics alone are insufficient, and antivirals are not indicated.
Reference: AAO BCSC Section 13: Refractive Surgery, 2022-2023 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.