LASIK术后角膜瓣移位的临床特点及处理

目的分析LASIK术后角膜瓣移位发生原因、临床特征及处理方法。方法对15例15只眼Lasik术后发生角膜瓣移位导致角膜瓣皱褶的患者行裂隙灯观察、验光、角膜地形图检查,同时观察复位术后的变化。结果本资料角膜瓣移位,发生于术后24h内发生的有8例8只眼,均于术后次日复诊发现,术中过度操作、薄瓣、窄蒂、术后揉搓眼球、眼睑痉挛等是高危因素;7例7只眼发生在LASIK后2～26月,均与外伤有关。角膜瓣移位后24h主要表现为角膜刺激症状,以视力下降、重影、视物变形、眩光、最佳矫正视力下降为主,角膜瓣重新复位后均有不同程度的改善。结论 LASIK术后角膜瓣移位发生原因众多,会导致不同程度的视觉质量下降,及时正确处理是改善预后的关键。

Objective Analyze reason, clinical feature and treatment method of cornea-flap dislocation after LASIK operation. Methods Use slit lamp.optometry.corneal topography to examine 15 examples 15 eyes whose cornea-flap reductus because LASIK operation cornea-flap dislocated, and meanwhile to observe variation after postreduction. Results Among These cornea-flap dislocated data, 8 examples 8 eyes happened within 24 hours after operation, all were discovered next day when further consultation after operation, the high risk factors are excess operation, thin flap. narrow stem. to rub eyeball after operation and so on, and 7 examples 7 eyes happened among 2-26 month after LASIK operation, all are related to external injury.24 hours after cornea-flap dislocated, the main clinical manifestation is cornea irritation, primarily displayed cornea irritation, main displayed acuity of vision decent, double image, dysmorphopsia, dazzle, best corrected vision descent. These appearances can all improve after cornea-flap reset. Conclusion There are many reasons for cornea-flap display, they can lead to diversity degree visual quality decrease, the key point for improve prognosis is to treat it in time and correctly.