Wiping microkeratome blades with sterile 100% alcohol to prevent diffuse lamellar keratitis after laser in situ keratomileusis

Purpose: To report our experience in preventing diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK) by wiping the microkeratome blade with sterile 100% alcohol. Setting: Enaim Refractive Surgery Center, Jerusalem, Israel. Methods: Laser in situ keratomileusis was performed in 24 patients (48 eyes) on the same day by the same surgeon. The environment and instruments were identical in all cases. A new blade was used in both eyes of each patient. All blades were from the same batch and were randomly assigned to 2 groups. In the alcohol group, 12 blades were wiped with a Merocel(R) surgical spear (Medtronic Solan) dipped in 100% alcohol and rinsed with balanced salt solution (BSS(R)) before they were mounted in a Hansatome(R) microkeratome (Bausch Lomb Co.); in the control group, 12 blades were wiped with a Merocel surgical spear dipped in BSS and rinsed with BSS. All patients were examined on the first postoperative day. Results: Grade I to 11 DLK was diagnosed in 7 eyes of 4 patients in the control group (29%). No DLK was diagnosed in the alcohol group. Conclusion: Wiping the microkeratome blade with 100% alcohol before mounting may remove a substance from the manufacturing or sterilization process that can cause DLK. (C) 2003 ASCRS and ESCRS