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Fs-LASIK术中中央角膜上皮剥脱处理一例
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Abstract:
飞秒辅助准分子激光原位角膜磨镶术(femosecond laser in situ keratomileusis, Fs-LASIK)术中角膜中央上皮剥脱是较少发生的一类并发症，它会增加感染性角膜炎、弥漫性层间角膜炎(diffuse lamellar keratitis, DLK)和复发性角膜上皮糜烂的发生风险。本文报告一例单眼Fs-LASIK术中出现中央角膜上皮大片剥脱的患者，戴绷带镜治疗后角膜上皮出现缺氧、弥漫上皮缺损的情况，停绷带镜后上皮修复又合并DLK，抗炎治疗后再次出现上皮剥脱的治疗经过。本病例通过分析LASIK术中出现中央角膜上皮剥脱用药及绷带镜使用的要点，提示临床医生对于Fs-LASIK术中出现的中央角膜上皮剥脱应谨慎对待，注意绷带镜使用后的反应，密切随访及时调整用药，确保上皮的及时修复，避免感染、炎症和复发造成的视力损害。
Femtosecond laser-assisted in situ keratomileusis (Fs-LASIK) is a type of corneal refractive surgery. Central corneal epithelial defect during Fs-LASIK is an uncommon complication that can increase the risk of infectious keratitis, diffuse lamellar keratitis (DLK), and recurrent corneal epithelial erosion. This article reports a case of a patient who experienced large-scale central corneal epithelial defect during unilateral Fs-LASIK. After bandage contact lens treatment, the corneal epithelium exhibited hypoxia and diffuse epithelial defects. Subsequent removal of the bandage contact lens resulted in epithelial repair but accompanied by DLK. The treatment course included addressing epithelial exfoliationafter anti-inflammatory therapy. Through analysis, this case highlights the importance of medication and proper use of bandage lenses when managing central corneal epithelial exfoliation during Fs-LASIK. Clinical practitioners should exercise caution, closely monitor post-bandage contact lens reactions, adjust medication promptly to ensure timely epithelial repair, and prevent vision impairment caused by infection, inflammation, and recurrence.
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