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LASIK and the Ocular Surface

机译：LASIK和眼表

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摘要

Wound healing after LASIK sometimes compromises homeostasis of the ocular surface. Diffuse lamellar keratitis is a post-LASIK inflammatory condition in the interface that appears during the first week after LASIK. The etiology of diffuse lamellar keratitis is unknown, but the association with allergic reaction to detergent, bacteria, and other chemicals is suspected. The condition is mostly self-limiting. Topical and/or oral corticosteroids may be effective against stage 2 disease, whereas flap lift and irrigation might be required in stage 3. Epithelial ingrowth occurs in about 1% of LASIK eyes. Although most cases heal spontaneously, some require surgical removal. There are 2 known mechanisms for epithelial ingrowth: epithelial invasion and epithelial implantation. Epithelial invasion grows in 2 distinct ways-outside invasion and flap epithelial invasion. The latter type is often seen after enhancement and may be treatment resistant. Patients with compromised attachment of corneal epithelium before LASIK may develop recurrent corneal erosion, which sometimes requires phototherapeutic keratectomy. Subepithe-lial opacity after viral infection, even long after infection, often recurs after LASIK and affects refraction and visual acuity. Topical corti-costeroid may be effective to prevent recurrence. Dry eye is a common complication after LASIK. Although post-LASIK dry eye is usually temporary, some patients complain of severe symptoms that may negatively influence their satisfaction with the outcome. For example, functional visual acuity significantly decreases after LASIK. The possible mechanisms for post-LASIK dry eye may be associated with loss of neurotrophic effect, damage of goblet cells, and altered corneal shape.
机译：LASIK手术后的伤口愈合有时会损害眼表的稳态。弥漫性层状角膜炎是LASIK术后的炎症状态，出现在LASIK术后的第一周。弥漫性层状角膜炎的病因尚不清楚，但怀疑与对清洁剂，细菌和其他化学物质的过敏反应有关。这种情况主要是自限性的。局部和/或口服皮质类固醇可能对2期疾病有效，而在3期可能需要皮瓣抬高和冲洗。大约1％的LASIK眼上皮向内生长。尽管大多数情况下会自愈，但有些情况需要手术切除。有两种已知的上皮向内生长机制：上皮浸润和上皮植入。上皮浸润以两种不同的方式生长-外部浸润和皮瓣上皮浸润。后一种类型通常在增强后可见，并且可能具有治疗抗性。 LASIK手术前角膜上皮附着受损的患者可能会发生复发性角膜糜烂，有时需要进行光疗性角膜切除术。病毒感染后，即使感染后很长一段时间，上皮下混浊也经常在LASIK术后复发，并影响屈光度和视力。外用皮质类固醇可能有效预防复发。干眼是LASIK术后的常见并发症。尽管LASIK术后干眼通常是暂时的，但一些患者抱怨严重的症状可能会对他们对结果的满意度产生负面影响。例如，LASIK术后功能性视力明显下降。 LASIK术后干眼的可能机制可能与神经营养作用的丧失，杯状细胞的损伤和角膜形状改变有关。

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  • 来源
    《Cornea》 |2008年第8suppla期|共7页
  • 作者

    Ikuko Toda;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 眼科学;
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  • 入库时间 2022-08-18 09:43:30

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