Severe Corneal Blood Staining—A Diffuse Lamellar Keratitis Mimic

Purpose: This report aims to describe a novel case of corneal blood staining, leading to the deposition of hemoglobin and its breakdown products in the laser-assisted in situ keratomileusis (LASIK) flap interface. Methods: We report a case of a 49-year-old man with a history of LASIK who presented with interface haze and posterior stromal blood staining after a pars plana vitrectomy complicated by a postsurgical hyphema with elevated intraocular pressure. Results: The interface haze was initially treated as diffuse lamellar keratitis; however, there was no response to treatment with intensive topical corticosteroids. Over time, it became apparent that the interface opacity was related to the dense corneal blood staining likely caused by the deposition of hemoglobin and its breakdown products in the flap interface, resulting from a total hyphema and increased intraocular pressure. The cornea completely cleared with observation over a 2-year period. Conclusions: To our knowledge, this is the first case report of hyphema-related corneal blood staining causing a dense LASIK interface opacity that resolved over time without surgical intervention.