Insights in Cataract and Refractive Surgery

Case Report

Diffuse lamellar keratitis after small incision lenticule extraction: presumably related to meibomian gland dysfunction: Sang Beom Han; Insights Cataract Refract Surg 2025;10(2):61-64. Published online June 30, 2025; DOI: https://doi.org/10.63375/icrs.25.008

Abstract PDF ePub: Purpose
This report presents a case of diffuse lamellar keratitis (DLK) after femtosecond laser-assisted small incision lenticule extraction (SMILE). The case was presumably associated with meibomian gland dysfunction (MGD).
Case
summary: A 25-year-old male patient underwent SMILE surgery. Preoperative examination revealed MGD in both eyes. Despite vigorous cleaning of the eyelid margin and irrigation of the ocular surface, meibomian gland secretion floating on the ocular surface was observed after the lenticule extraction in the right eye. At 2 days postoperatively, stage I DLK was detected. After aggressive topical steroid treatment, the DLK completely resolved without any sequalae.
Conclusion
DLK can occur in association with MGD. Attention should be paid when performing SMILE in eyes with MGD.

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