Melting

Abstract

The cornea experiences a limited number of responses to a wide variety of aggressions. Stromal melting, also known as keratolysis or stromal necrosis, is an end-stage response of potentially serious consequences. The wounded area is optically dense after experiencing melting. It rarely returns to its normal tensile strength, mainly because the corneal thickness is reduced. The therapeutic approach must be directed toward the underlying disease or "trigger" phenomenon and it will depend on the aggressivity of the melt. Although stromal melting most frequently occurs after LASIK, it has also occasionally been observed after other corneal refractive procedures. Both epithelial ingrowth and melting of the flap edge are more common in LASIK re-treatments involving flap relift and after hyperopic re-treatments. Melting is commonly associated with inflammatory disorders of the interface, such as diffuse lamellar keratitis (DLK).