Diffuse lamellar keratitis 14 years after laser in situ keratomileusis induced by an eyelash in the flap interface

We describe a case of unilateral late-onset diffuse lamellar keratitis (DLK) in a 45-year old man 14 years after uneventful laser in situ keratomileusis (LASIK) surgery associated with an eyelash in the flap interface. The patient presented initially with a 1.0 mm central epithelial defect with haze, infiltrate, and epithelial ingrowth along the LASIK flap in the left eye. The initial corrected distance visual acuity was 20/60 in the right eye and 20/125 in the left eye. Two weeks after the flap was refloated and topical steroid treatment administered, the corrected distance visual acuity was 20/20 in both eyes. This report describes an exceedingly rare presentation of DLK 14 years after LASIK triggered by a foreign body under the LASIK flap.