准分子激光原位角膜磨镶术后界面性角膜炎的临床观察

目的 :动态观察准分子激光原位角膜磨镶术 (LASIK)后界面性角膜炎 (DLK)的临床变化 ,同时对其角膜瓣下临床特点及处理方法进行分析。　方法 :对 35 0 0例行LASIK后 1 0例 (1 8只眼 )发生DLK患者进行观察。按3、7、1 4天和 1、2、6个月不同时间进行视力、裂隙灯显微镜检查。　结果 :局部用激素、抗生素治疗 1周 ,症状控制 ,1～ 2个月全部吸收。视力恢复至 1 .0～ 1 .5 (1 6只眼 ) ,0 .8～ 1 .0 (2只眼 )。　结论 :LASIK后DLK常发生在术后 1～ 7天内 ,迟发者偶见 ,男性多于女性 ,以局部激素治疗为主 ,严重患者需全身激素加抗生素治疗。DLK早期须与角膜上皮植入、层间感染鉴别

Clinical observation of diffuse lamellar keratitis after excimer laser in situ keratomileusis

Objectives: To observe the clinical course of diffuse lamellar keratitis(DLK) after laser in situ keratomileusis(LASIK) and to investigate the presentation and management of DLK. Methods:Among 3500 patients underwent LASIK in our center, 18 eyes in 10 patients received DLK were examined. All eyes were examined with slitlamp biomicroscope at the course of 3 days,7 days,14 days,1 month, 2 months and 6 months after the operation. Visual actuity was measured. Results:Symptoms were controlled after 1 week treatment of topical corticosteroids and antibiotics. Resolution of DLK occurred after 1 to 2 months. Uncorrected visual acuity is 1.0 to 1.5 in 16 eyes and 0.8 to 1.0 in 2 eyes. Conclusions:DLK is a complication after LASIK, it usually occurs in 1 to 7 days postoperatively, more likely in male. Topical corticosteroids and antibiotics can get a satisfied outcome. Systemic corticosteroids and antibiotics are needed in serious cases. Early stage of DLK must be distinguished from corneal epithelial implantation and interface infection.