LASIK术后角膜层间积液综合征临床特点的系统评价  

Clinical characteristics of interface fluid syndrome after LASIK:a systematic review

作　　者：何晴 王秀 谷天瀑 解偲媛 魏瑞华[1] He Qing;Wang Xiu;Gu Tianpu;Xie Caiyuan;Wei Ruihua(Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science,Eye Institute and School of Optometry,Tianjin Medical University Eye Hospital,Tianjin 300384,China)

机构地区：[1]天津医科大学眼科医院,天津医科大学眼视光学院,天津医科大学眼科研究所天津市眼科学与视觉科学国际联合研究中心,300384

出　　处：《中华实验眼科杂志》2021年第6期557-562,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目(81770901)。

摘　　要：目的对准分子激光角膜原位磨镶术(LASIK)术后角膜层间积液综合征(IFS)的临床特点进行系统评价。方法采用电子文献数据库,检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据库、中国科技期刊数据库关于角膜IFS文献报道,检索年限为1999—2021年。文章筛选、数据提取、质量评级及数据分析参照系统综述和Meta分析优先报告条目的PRISMA声明进行。结果共纳入30篇文献,包括46例62眼病例,其中男34例47眼,女12例15眼;年龄19~69岁,平均(36.57±13.40)岁;双眼16例,单眼30例。85.48%(53/62)的IFS是由于LASIK术后眼压升高引起。纳入的46例62眼均有视力下降。其中24.19%(15/62)患眼出现眼痛、眼红、畏光。46例患者裂隙灯显微镜下均可见不同程度的角膜水肿、角膜层间积液,9.68%(6/62)患眼可见角膜后沉着物、前房细胞,16.13%(10/62)患眼出现视野损伤。治疗上77.42%(48/62)行降眼压药物治疗。有预后描述的31例40眼患者中,75.00%(30/40)患眼经治疗视力恢复,25.00%(10/40)视力无法恢复。结论角膜IFS作为LASIK术后少见的并发症,在LASIK术后角膜水肿患者的诊断中应考虑此病,正确测量眼压,合理应用糖皮质激素及降眼压药物,避免不可恢复的视力下降。Objective To evaluate the clinical features of interface fluid syndrome(IFS)after laser in situ keratomileusis(LASIK).Methods We searched PubMed,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure Database,Wanfang Database,and Chinese Science and Technology Periodical Database for literature reports on IFS published from 1999 to 2021.Article selection,data extraction,quality rating,and data analysis were performed with reference to the PRISMA statement for priority reporting entities of systematic reviews and Meta-analysis.Results A total of 30 publications were included,including 46 cases(62 eyes).Among them,34 cases(47 eyes)were male and 12 cases(15 eyes)were female.Age ranged from 19 to 69 years with a mean of(36.57±13.40)years.There were 16 cases of bilateral eyes and 30 cases of monocular eyes.The 85.48%(53/62)of IFS was due to increased intraocular pressure(IOP)after LASIK.All 62 eyes included had decreased visual acuity.The 24.19%(15/62)of the affected eyes had ocular pain,redness,and photophobia.All 46 patients showed different degrees of corneal edema and interface fluid.Keratic precipitates and anterior chamber cells were visible in 9.68%(6/62)of the affected eyes,and 16.13%(10/62)showed visual field damage.IOP-lowering eye drops were given to 77.42%(48/62)of eyes.Of the 31 patients(40 eyes)with prognostic descriptions,and 75.00%(30/40)recovered their vision with treatment and 25.00%(10/40)did not.Conclusions IFS is a rare complication after LASIK.It should be considered in patients with corneal edema after LASIK.Proper measurement of IOP and reasonable application of glucocorticoids and IOP-lowering drops can prevent irreversible vision loss.

关 键 词：准分子激光原位角膜磨镶术 角膜层间积液综合征 高眼压 系统评价 

分 类 号：R779.63[医药卫生—眼科]