Surgical-glove–related diffuse lamellar keratitis after laser in situ keratomileusis

Abstract

Early diagnosis and appropriate treatment of glove-related DLK provided visual outcomes that were similar to those in eyes with an uneventful postoperative course. These good results are consistent with those in studies of classic DLK.

Diffuse lamellar keratitis after laser in situ keratomileusis associated with surgical marker pens

“…There are few reports of outbreaks of DLK, 5,13 and the specific causative factor is usually not known. It is generally agreed that DLK is caused by a contaminant in the [4][5][6][7][8][9][10][11][12][13][14][15] have been shown to be associated with DLK. To our knowledge, there are no previous reports of an association between the use of surgical marker pens and DLK.…”

“…They include meibomian gland secretions, silicates, microkeratome oil, hemoglobin, povidone-iodine solution, bacterial endotoxin, metallic fragments, cleaning solutions, toxic chemicals, and silicone oil on surgical gloves. [4][5][6][7][8][9][10][11][12][13][14][15] In this paper, we report a cluster of DLK cases that was associated with a particular brand and batch of surgical markers used during the LASIK procedure. At the Singapore National Eye Centre (SNEC), there are strict protocols for the introduction of new equipment and consumables (including new batches of consumables) for all LASIK procedures performed.…”

LASIK interface keratitis: epidemiology, diagnosis and care

“…During epidemics, factors found to be responsible for outbreaks include endotoxin contamination of sterilizers [30][31][32], certain types of surgical gloves [33,34], certain types of surgical marking pens [35,36], exposure of surgical instruments to toxic chemicals [37] and certain detergents used in cleaning surgical instruments [38]. If an outbreak is suspected, a methodical investigation should be performed to discover and correct the inciting factor.…”

A Case Report of Diffuse Lamellar Keratitis after FemtoSMILE Refractive Surgery

“…Conversely, in outbreaks, a more generalized etiology would seem reasonable for the escalation of these case clusters. For instance, contamination of steam sterilizers with endotoxins as well as marking surgical pens and gloves were all found to be highly influential in the spread of outbreaks in epidemic areas [3-7].…”