角膜层间积液综合征的临床分析  

The clinical analysis of corneal interface fluid syndrome

作　　者：庞辰久[1] 王丽娅[1] 彭海鹰[1] 李金[1] 李舒茵[1] 牛超[1] 尹卫靖[1] 

机构地区：[1]河南省眼科研究所河南省角膜病重点实验室,郑州450003

出　　处：《中华眼科杂志》2012年第10期924-929,共6页Chinese Journal of Ophthalmology

摘　　要：目的探讨层间积液综合征（IFS）的发病原因、临床表现、激光扫描共焦显微镜检查特点以及治疗中存在问题。方法回顾性系列病例研究。对河南省眼科研究所2007年1月至2011年10月诊治的8例IFS患者的临床资料包括性别、年龄、病史等详细询问并行裂隙灯显微镜、眼前节相干光断层成像术（OCT）、激光扫描共焦显微镜以及眼底、视野等检查。结果8例患者中双眼4例、单眼4例，共12只眼。男性6例，女性2例，年龄19～35岁。发病原因分别为准分子激光原位角膜磨镶术（LASIK）后糖皮质激素性高眼压2例（4只眼），原发性开角型青光眼2例（4只眼），青光眼一睫状体炎综合征1例（1只眼），色素性青光眼1例（1只眼），外伤性葡萄膜炎1例（1只眼），LASIK术后上皮植入反复冲洗内皮损伤1例（1只眼）。裂隙灯显微镜检查可见角膜水肿、角膜层间混浊、层问积液；眼前节OCT检查可见角膜层间积液或混浊；激光扫描共焦显微镜检查可见角膜水肿，角膜瓣增厚，基质细胞减少，角膜皱褶。结论IFS为LASIK术后严重威胁视力的并发症，发病原因主要为高眼压和角膜内皮损伤，详细的裂隙灯显微镜检查辅以眼前节OCT检查可明确诊断，针对不同原因早期合理治疗才能最大限度挽救患者视力。（中华聪科杂志，2012，48：924-929）Objective To analysis the clinical characteristics of corneal interface fluid syndrome （IFS）. Methods This is a retrospective study. During Jun. 2007 to Oct. 2011. Eight cases （12 eyes） of IFS were diagnosed at Henan Eye Institute. The history and complete ophthalmic examination that include Slit-lamp examination, Slit-lamp photography, IOP, anterior segment OCT （AS-OCT）, confocal microscopic exams were recorded. Results In total 8 cases （ 12 eyes）, 4 cases were bilateral, 4 cases were unilateral. Six patients were male and 2 were female. The age of the patients ranged from 19 to 35 years. Post-lasik steroid-induced elevated IOP was 4 eyes in 2 patients. Primary open angle glaucoma was 4 eyes in 2 patients. 1 patient （ 1 eye） was Posner-Shlossman syndrome, 1 patient （ 1 eye） was pigmented glaucoma, 1 patient （ 1 eye） was post-lasik traumatic iritis. 1 patient （ 1 eye） got IFS after repeated flap reposition because of epithelium ingrowth. Slit-lamp exam indicated edematous corneal, lamellar haze, interface fluids accumulation. AS-OCT showed obvious interface dark area. Confocal microscopy exam showed edematous corneal flap, more oval and large keratocytes＇ nuclei but no inflammatory cells. Conclusions IFS is a rare but serious complication after LASIK. The main causes are high intraocular pressure and/or dysfunction of corneal endothelium. Careful exam by slit-lamp may help diagnosis, and further AS-OCT and/or in vivo confocal microscopy exam will confirm it. （Chin J Ophthalmol, 2012,48：924-929）

关 键 词：角膜水肿 高眼压 手术后并发症 

分 类 号：R772.2[医药卫生—眼科]