飞秒激光制瓣激光原位角膜磨镶术后上皮植入的原因与处理  

Cause and management of epithelial ingrowth after femtosecond laser-assisted in situ keratomileusis

作　　者：王丽霞 林青鸿 

机构地区：[1]厦门大学附属厦门眼科中心,厦门361001

出　　处：《中华眼外伤职业眼病杂志》2017年第11期811-814,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨飞秒激光制瓣激光原位角膜磨镶术（FS—LASIK）后角膜上皮植入的原因、处理和疗效。方法回顾分析3628例（7160只眼）FS—LASIK术后发生的角膜上皮植入23只眼，并对其发生原因、处理方法进行分析。结果术后1～2周发现上皮植入者20只眼，其中90μm角膜瓣16只眼，110μm角膜瓣4只眼；术后1年外伤碎瓣1只眼，术后2年外伤性角膜瓣皱褶2只眼。14只眼采用了掀开角膜瓣刮除植入的上皮，其中6只眼辅助以激光治疗性角膜切削术（PTK）治疗，1只眼外伤后碎瓣行去瓣术，非掀瓣保守观察治疗8只眼。经治疗后18只眼达到术前矫正视力，4只眼低于术前矫正视力1行，去瓣术后的1只眼出现hazeⅡ级，视力0．5，低于术前最佳矫正视力3行。结论上皮植入为FS-LASIK术后的严重并发症之一，经早期发现、及时正确的处理后仍可获得良好的治疗效果。Objective To investigate the cause, management and efficacy of epithelial ingrowth after femtosecond laser-assisted in situ keratomileusis （FS-LASIK）. Methods Twenty-three eyes of epithelial ingrowth from 7 160 eyes of 3 628 cases after FS-LASIK were collected. The causes and management were observed and analyzed retrospectively. Results The epithelial ingrowth occurred in 20 eyes 1-2 weeks after surgery, in which 16 eyes with 90μm thickness of corneal flap, 4 eyes with 110 μm thickness of corneal flap. One year after surgery corneal flap broken caused by trauma in 1 eye. Traumatic corneal flap flods happened in 2 eyes 2 years after surgery. The corneal flap lifting and ingrowth epithelial sweeping was performed in 14 eyes, among them 6 eyes received ingrowth epithelial sweeping combined with phototherapeutic keratectomy （PTK）. The corneal flap removed in 1 eye, 8 eyes received conservative medication without corneal flap lifting. After treatment the visual acuity of 18 eyes achieved preoperative best corrected visual acuity; 4 eyes visual acuity were 1 line below the corrected vision preoperative and haze Ⅱ grade occurred in 1 eye with 3 lines below the preoperative corrected visual acuity. Conclusion The epithelial ingrowth after FS-LASIK is one of serious complications. Early diagnosis and treatment are the key of decreasing the incidence of epithelial ingrowth after FS-LASIK.

关 键 词：飞秒激光制瓣激光原位角膜磨镶术(FS-LASIK) 上皮植入 角膜瓣 

分 类 号：R779.63[医药卫生—眼科]