LASIK术后弥漫性板层角膜炎的发病机制及药物调控

Pathogenesis and medication of DLK after LASIK

弥漫性板层角膜炎(DLK)为准分子激光原位角膜磨镶术(LASIK)术后的一种非感染性炎症。其发病机制可分为内源性、外源性及宿主特异性,其中IL-1、IL-8、TNF-α、内毒素、遗传过敏症、角膜内皮细胞密度及功能等分别参与了不同发病机制的过程。目前的药物治疗及预防主要包括糖皮质激素、LAU0901、非甾体抗炎药及0.5%羧甲基纤维素钠,其中糖皮质激素的术中使用在预防方面具有其独特的优越性。就LASIK术后DLK的发病机制及药物控制进行综述。

Diffuse lamellar keratitis（DLK） is a noninfectious inflammation following laser in situ keratomileusis（LASIK）. It can cause complications such as nontolerance of light, lacrimation and reduce of best spectacle corrected visual acuity. The pathogenesis includes endogenous, exogenous and hostspecificity. IL-1, IL-8, TNF-ct, endotoxin, inherited allergy, density and function of keratic endothelial cells play different roles during the process. The current drugs available comprise mainly of glucocorticoid, LAU0901, NASIDs and 0.5 % ketorolac tromethamine. The application of glucocorticoid after the corneal flap is of the dominant effect during the operation and its specific advantage in preventing and treating DLK.