准分子激光原位角膜磨镶术后弥散性板层角膜炎的鉴别和处理

The Differential Diagnosis and Management of Diffuse Lamellar Keratitis after Excimer Laser in Situ Keratomileusis

目的:鉴别准分子激光原位角膜磨镶术(LASIK)后早期弥散性板层角膜炎,为其治疗提供帮助。方法:回顾性分析我科LASIK 1014例(2020眼),术后根据视力、是否有眼分泌物,裂隙灯下结膜充血情况、角膜瓣透明度等进行鉴别,并做相应的处理。结果:术后1天,诊断为弥漫性板层角膜炎3例(6 眼),其中Ⅰ期2眼,Ⅱ期4眼,根据病因予局部皮质类固醇和抗生素治疗,所有患者痊愈。结论:弥散性角膜炎是LASIK后较严重的并发症,仔细鉴别并采取积极治疗可获较好预后。

Objective： To differential diffuse lamellar keratitis （DLK） after excimer laser in situ keratomileusis （LASIK） and give proper management. Methods：The postoperative clinical manifestations of 1014 cases （2020 eyes） were retrospective observed, including visual acuity, eye secrections, eonjunetival hyperemia, corneal flap transparency. The proper managements were performed tilter differential diagnosis. Results：3 cases （6 eyes） were diagnosed DLK. Among them, 2 eyes were in DLK I stage and 4 eye were in DLK Ⅱ stage. All patients were fully recovered after using corticosteroid and antibacterial eye drops. Conclusion：DLK is a more important postoperative complication after LASIK. The better prognosis depends on differential diagnosis carefully and proper management in time.