Diffuse lamellar keratitis: Incidence, associations, outcomes, and a new classification system
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
PURPOSE: To evaluate the incidence, associations, and visual outcomes in patients with diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK). SETTING: University-based refractive surgery center, Boston, Massachusetts, USA. METHODS: This retrospective review comprised 2711 eyes that had LASIK between September 1996 and September 1999. All eyes that developed DLK after LASIK were included. They were divided into type I DLK (center sparing) or type II DLK (center involved) and then subdivided into A (sporadic-DLK not diagnosed in other patients treated on the same day) or B (cluster-other patients identified with DLK). Type IA corresponded to center sparing, sporadic; type IB, center sparing, cluster; type IIA, center involved, sporadic; and type IIB, center involved, cluster. The main outcome measures were incidence of DLK after LASIK, time to diagnosis, time to resolution, and changes in best spectacle-corrected visual acuity (BSCVA). Unpaired t tests were used for statistical analyses. RESULTS: Thirty-six eyes (1.3%) developed DLK. Type I occurred in 58.3% of cases (type IA, n = 18; type IB, n = 3) and type II, in 41.7% (type IIA, n = 10; type IIB, n = 5). The mean time to diagnosis was not statistically significantly different between type I (1.8 days) and type II (1.1 days). Fourteen eyes (38.9%) developed DLK after an epithelial defect, representing an odds ratio of 13 times. The association with an epithelial defect was statistically significantly greater with type I (11/21 eyes, 52.4%) than with type II (3/15 eyes, 20.0%; P =.05). The mean time to resolution was 3.5 days in type I (type IA = 3.6 days; type IB = 2.7 days). This was significantly shorter than in type II, which had a mean time to resolution of 12.1 days (type IIA = 9.3 days; type IIB = 10.2 days) (P =.001). Loss of 2 or more lines of BSCVA occurred in 2 of 5 patients with type IIB and in no patients with types IA, IB, or IIA. CONCLUSIONS: Epithelial defects after LASIK increased the risk of DLK occurrence, especially type I. Type II DLK was associated with a prolonged time to resolution and carried a significantly higher risk of BSCVA loss than type I.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it