经上皮准分子激光角膜切削术后角膜上皮延迟愈合1例  

Delayed corneal epithelial healing after trans-epithelial photorefractive keratectomy:a case report

作　　者：王天骄 李莹 WANG Tianjiao;LI Ying(4+4 Medical Doctor Program,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Ophthalmology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院、北京协和医学院,北京100730 [2]中国医学科学院、北京协和医学院北京协和医院眼科,北京100730

出　　处：《基础医学与临床》2023年第6期981-984,共4页Basic and Clinical Medicine

摘　　要：目的探讨经上皮准分子激光角膜切削术(TPRK)术后角膜上皮延迟愈合原因及治疗。方法回顾性分析1例青年女性因近视行TPRK后出现角膜上皮延迟愈合的临床资料。结果角膜上皮延迟愈合是TPRK术后早期少见并发症。本例患者因TPRK术后角膜上皮延迟愈合出现眼部疼痛、视物模糊、眩光流泪等症状。长期配戴隐形眼镜、睑板腺功能障碍及术后使用抑制上皮生长药物是其危险因素,患者经过配戴绷带镜、玻璃酸钠滴眼液、小牛血去蛋白提取物眼用凝胶、糖皮质激素、更昔洛韦眼用凝胶、角膜上皮清创刮除术等综合治疗22 d后,角膜上皮完全愈合,延迟愈合区域角膜上皮下雾状混浊1级,半年后角膜透明无浑浊。结论对具有TPRK术后角膜延迟愈合危险因素的患者,术前应进行全面检查以减少角膜上皮延迟愈合风险;当出现术后角膜上皮延迟愈合时应及早进行综合治疗,警惕角膜上皮下雾状混浊和单纯疱疹病毒感染。Objective To investigate the causes and treatment of delayed corneal epithelial healing after trans-epithelial photorefractive keratectomy(TPRK).Methods A case of a young female with delayed corneal epithelial healing after TPRK for myopia was retrospectively analyzed.Results Delayed corneal healing is a rare complication in the early stage after TPRK.In this case,it caused symptoms such as pain,blurred vision,glare and tearing.Long-term wearing of contact lenses,meibomian gland dysfunction and postoperative use of drugs that inhibited epithelial growth were risk factors for this patient.After comprehensive treatment with bandage soft contact lenses,sodium hyaluronate,deproteinized calf blood extractive,glucocorticoids,ganciclovir ophthalmic gel and corneal epithelial debridement,corneal epithelium healed completely,but haze grade 1 was present in the delayed healing area on 22nd postoperative day.After follow-up treatment,haze disappeared and cornea returned transparent half a year later.Conclusions Patients with risk factors for delayed corneal epithelial healing after TPRK should undergo a comprehensive preoperative examination.Delayed corneal epithelial healing should be treated early and comprehensively,while alerting to haze and herpes simplex virus infection.

关 键 词：近视 经上皮准分子激光角膜切削术 角膜上皮缺损 

分 类 号：R772.2[医药卫生—眼科]