角膜屈光术后群发性弥漫性层间角膜炎的临床研究  

Clinical study of the clusters of diffuse lamellar keratitis after laser corneal refractive surgery

作　　者：林青鸿[1] 王丽霞[1] 

机构地区：[1]厦门大学附属厦门眼科中心,中国福建省厦门市361000

出　　处：《国际眼科杂志》2017年第6期1150-1152,共3页International Eye Science

摘　　要：目的:回顾分析我院角膜屈光术后群发性弥漫性层间角膜炎(diffuse lamellar keratitis,DLK)发病原因和治疗。方法:收集我院2016-02-10/22期间于我院行角膜屈光手术(包括LASIK手术,FS-LASIK,SMILE)后出现DLK患者53例98眼,分析其发病原因并根据其程度和范围制定相应的治疗方案,并观察治疗后1、3、5、7、10d及1mo时的恢复情况。结果:本研究中共发生5次群发性的DLK,在更换一次性手术用品、冲洗液以及对手术室的温湿度重新调整后,DLK的发生率明显降低。其中Ⅰ级DLK 80眼(82%)、Ⅱ级DLK 11眼(11%)、Ⅲ级DLK 4眼(4%)、Ⅳ级DLK 3眼(3%)。其中行FS-LASIK手术的发病率为40%(42例79眼),Hastome角膜刀辅助的LASIK术发病率为45%(5例10眼),SMILE手术组发病率为20%(6例9眼)。经过相应的激素治疗和掀瓣冲洗处理,均取得良好的治疗效果。结论:本次的群发性DLK可能与手术用品、术中冲洗液以及手术室的温湿度等因素有关。及时有效的预防、早期发现、早期诊断、分级治疗是减少DLK发生和并发症的关键。AIM- To investigate the potential causes and management of the clusters of diffuse lamellar keratitis DLK） after laser corneal refractive surgery. METHODS： The study enrolled 98 eyes （53 patients） complicated with DLK after receiving laser in situ keratomileusis （ LASIK）, FS - LASIK or small - incision lenticule extraction （SMILE） in our center from February 10th,2016 to February 22th,2016. They were given clinical classification treatments according to corneal layer inflammatory extent and then followed up after 1,3, 5, 7, 10d and lmo. RESULTS： The clusters of DLK occurred 5 times in the study period. The incidence and degree of DLK significantly decreased after changed the sterilization, surgical equipments, temperature and humidity of the operating room. There were 80 eyes （82%） had stage 1 DLK, 11 eyes （11%） had stage 2, 4 eyes （4%） had stage 3 and 3 eyes （3%） had stage 4. The incidence of DLK after FS-LASIK was 40% （79 eyes in 42 patients）, that after LASIK assistant by Hastome keratome was 45% （10 eyes in 5 patients）, that after SMILE was 20% （9 eyes in 6 patients）. After intensive treatment, as glucocorticoid treatment and flap lifting flushing, all cases recovered within 1 mo. CONCLUSION： The outbreak of DLK may be associated with the disposable item, flushing liquor, temperature and humidity of the operating room. Early diagnosis, prevention and treatment are the key of decreasing theincidence of DLK.

关 键 词：弥漫性层间角膜炎 并发症 群发性 SMILE 

分 类 号：R779.6[医药卫生—眼科]