Bilateral corneal opacities in a LASIK patient after the use of titanium eye shields

We report a case of bilateral corneal opacities in a laser in situ keratomileusis (LASIK) patient who subsequently had carbon dioxide (CO2) laser skin resurfacing. The presumed etiology of the visually significant corneal opacities was late-onset diffuse lamellar keratitis (DLK), secondary to traumatic corneal abrasions from the use of metal eye shields. The DLK went untreated for 1 month, resulting in permanent interface scarring and a corrected distance visual acuity of 20/30 in the patient’s right eye and 20/20 in the left eye. We think patients who have had LASIK and are planning to have CO2 laser skin resurfacing or any procedure that uses protective metal eye shields should be counseled about the risk for late-onset DLK as a potential complication. This warning is particularly germane now as an increasing number of patients who have had LASIK are entering the decades of life when cosmetic surgery is most likely to be sought.Financial DisclosureNeither author has a financial or proprietary interest in any material or method mentioned.