准分子激光角膜屈光术后角膜感染诊断与治疗回顾  

Review the diagnosis and treatment of infection of the cornea after excimer laser cornea refractive surgery

作　　者：李韵秋[1,2] 李静[2] 王梦雅[2] 李从心[2] 李素霞[2] 史伟云[2] 王婷[2] 

机构地区：[1]山东省医学科学院,青岛266071 [2]山东省眼科研究所山东省眼科医院,济南250021

出　　处：《临床眼科杂志》2015年第2期112-115,共4页Journal of Clinical Ophthalmology

基　　金：国家自然科学基金(81200726);山东省自然科学基金(ZR2012HQ041)

摘　　要：目的回顾性分析准分子激光角膜屈光术后早期角膜感染的诊断与治疗策略及视力转归。方法对2008年1月至2014年3月我院收治的因准分子激光术后早期角膜感染患者7例(8只眼)进行回顾性分析。根据患者病史、共焦显微镜或角膜病灶组织刮片等检查明确其感染类型,对症采用局部及全身药物治疗,对药物不能控制的感染采取手术治疗,并观察视力转归情况。结果患者8只眼全部诊断为细菌性角膜溃疡,其中8只眼病灶组织刮片检查为阳性,5只眼细菌培养阳性。4只眼(50.0%)经抗菌药物治疗达到溃疡愈合,4只眼(50.0%)行板层性角膜移植术治愈。治愈病例至溃疡愈合时,8只眼视力均较治疗前提高。结论感染性角膜炎是准分子激光术后早期发生的严重并发症,尽早明确诊断并积极治疗是控制感染、保存视力的关键。Objective Retrospective analysis of diagnosis and treatment strategies and visual acuity outcomes of the early corneal infection after excimer laser cornea refractive surgery.Methods Retrospective analysis 7 patients 8 eyes early postoperative corneal infection after excimer laser who treated in our hospital in 2008 January to 2014 March.Confirm the type of infection according to patient history, confocal microscopy or corneal tissue scraping test , using local and sys-temic drug treatment, take the operation if drug can not control the infection, and observe the visual prognosis.Results All patients with 8 eyes diagnosed as bacterial corneal ulcer, 8 eyes Lesions tissue smear examination, 5 eyes of bacterial culture were positive.4 eyes （50%） after anti bacteria drug treatment to the healing of ulcer, 4 eyes （50%） taking lamel-lar keratoplasty to cure.To the healing of ulcers, visual acuity of 8 eyes was improved compared with those before treat-ment.Conclusion Infective keratitis is a severe complication occ-urred after excimer laser refractive surgery, the key to control inf-ection, save sight is diagnosis and aggressive treatment as soon as possible.

关 键 词：准分子激光原位角膜磨镶术 准分子激光角膜上皮下磨镶术 感染 角膜屈光手术 

分 类 号：R779.63[医药卫生—眼科]