准分子激光原位角膜磨镶术后角膜铁质沉着的临床研究

目的 探讨准分子激光原位角膜磨镶术(LASIK)后出现角膜铁质沉着的发生率及临床特征及其相关因素.方法 搜集行LASIK手术患者39例(78眼),描述角膜铁质沉着特征,并分析其与术后时间、术前屈光度、泪膜破裂时间、泪膜分泌量结果及干眼症状的相关性.结果 78眼中有53眼(67.9％)发现有角膜铁质沉着,位于角膜上皮细胞层基底细胞部位,颜色从淡黄色到黄褐色均有,形状有环状、片状、条索状、点状等,均位于角膜中央,与相应角膜地形图对照,铁质沉着部分为角膜经切削后最低部位,即角膜曲率最小部位,或者为角膜切削边缘,即角膜曲率变化最大部位,也就是角膜最陡峭部位.角膜铁质沉着的出现与手术前屈光度、手术后时间呈正相关[r=0.410,P＜0.01;r =0.398,P＜0.01],与BUT、泪液分泌量、干眼症状之间无明显相关.结论 角膜铁质沉着是LASIK术后的临床体征之一,可能与LASIK术后泪池的形成有关,但其发生机制尚需进一步深入研究.

Clinical study of corneal iron deposits after laser in situ keratomileusis

Objective To report the occurrence and features of corneal iron deposition after laser in situ keratomileusis （LASIK）. Methods We evaluated 78 eyes undergoing LASIK. Corneal iron deposition was analyzed with respect to preoperative spherical equivalent, postoperative time interval, subjective complaints of dry eye tear break-up time（BUT） and Sehirrner＇s I test. Results There were 67.9 % of 78 eyes displaying a distinctive corneal iron deposition of variable density in a ring or patch configuration in the middle zone in the corneal basal epi- thelial cells. The appearance of this iron deposition was correlated positively with time after surgery and preoperative spherical equivalent. Conclusions Corneal iron deposition in a ring or patch can be associated with previous LASIK surgery. This iron deposition within the margin of the ablated zone or in the flatted zone develops from tear pooling after LASIK.