准分子激光原位角膜磨镶术后与瓣相关并发症及处理

目的：动态观察准分子激光原位角膜磨镶术(LASIK)术后发生与瓣相关并发症的临床变化，同时对角膜瓣下并发症临床特点及处理方法进行分析。方法：对该院及外院行LASIK术后发生瓣相关并发症的27例患者35只眼进行观察处理。按3、7、15、30和60天不同时间进行视力、裂隙灯等检查。结果：10例层间角膜炎患者经过1—2个月治疗，瓣下炎症全部吸收，视力恢复至0．8—1．5；9例瓣皱褶、异位，经复瓣处理，视力恢复至1．0—1．2；1例外伤瓣丢失，经异体角膜磨镶移植术后，视力恢复至0．5—0．6；1例角膜瓣下感染、溶解，经去除病变角膜瓣加准分子激光治疗性切削术(PTK)治疗后角膜上皮愈合，但出现角膜瓣下雾状混浊(Haze)现象；3例3只眼上皮植入经掀瓣刮除处理，视力最后达0．8—1．0；3例3只眼角膜瓣形成不全，6个月后再次手术，视力达1．0—1．2。结论：LASIK术后与瓣相关并发症发生时间不等，临床以早发现、早处理恢复好。强调手术的规范性，建立严格的随访制度，将LASIK手术的并发症降至最低。

Flap complications after laser in situ keratomileusis:clinical changes and treatment

Objective:To observe the flap complications after LASIK and analyze their clinical characters and treatment. Methods:The flap complications after LASIK in 35 eyes of 27 patients was reviewed.Visual acuity were measured at 3,7,15,30,60 days after the operation,at the same time, the eyes were examined with slit lamp. Results:After the therapy,diffuse lamellar keratitis of 10 eyes were recovered in 1 to 2 months,the visual acuity were 0.8 to 1.5.Flap slippage of 9 eyes were treated with replacement and the visual acuity were 1.0 to 1.2.One eye with trauma induced flap lose underwent allogeneic keratomileusis and the visual actity was 0.5 to 0.6.One eye with interface infection was treated by removing the infected flap and PTK.The corneal surface was healed but remained with little haze.The visual acuity were 0.8 to 1.0 after the therapy in three eyes with epithelial ingrowth.Three eyes with fiap breaking in the procedure were reoperated half a year later,and the visual acuity were 1.0 to 1.2. Conclusion:Flap complications after LASIK occurred at various period and are related with surgical technic,patient~(,)s eyes conditions and the treatment after the surgery.Early detection and therapy can obtain an comparatively excellent recovery.