Lemley H L, Chodosh J, Wolf T C, Bogie C P, Hawkins T C
Department of Ophthalmology, Dean A. McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
J Refract Surg. 2000 May-Jun;16(3):373-4. doi: 10.3928/1081-597X-20000501-14.
A patient developed significant corneal complications from air bag deployment, 17 months after laser in situ keratomileusis (LASIK).
Case report, slit-lamp microscopy, and review of the medical literature.
A 37-year-old woman underwent bilateral LASIK with resultant 20/20 uncorrected visual acuity. Seventeen months later, she sustained facial and ocular injuries from air bag deployment during a motor vehicle accident. Examination revealed bilateral corneal abrasions, partial dislocation of the right corneal LASIK flap, and a hyphema in the right eye. The LASIK flap was realigned, but recovery was complicated by a slowly healing epithelial defect and flap edema. One month following the injury, epithelial ingrowth beneath the LASIK flap was noted. Surgical elevation of the flap and removal of the epithelial ingrowth was performed. Eight months later, epithelial ingrowth was absent and the visual acuity was 20/40. Residual irregular astigmatism necessitated rigid gas permeable contact lens fitting to achieve 20/20 visual acuity.
Air bags may cause significant ocular trauma. The wound healing response of LASIK allows corneal flap separation from its stromal bed for an indeterminate time after surgery. Discussion of the possible risk of corneal trauma as part of informed consent prior to LASIK may be appropriate.
一名患者在准分子原位角膜磨镶术（LASIK）后17个月因安全气囊展开出现了严重的角膜并发症。
病例报告、裂隙灯显微镜检查及医学文献回顾。
一名37岁女性接受了双侧LASIK手术，术后裸眼视力达到20/20。17个月后，她在机动车事故中因安全气囊展开而面部和眼部受伤。检查发现双侧角膜擦伤、右眼角膜LASIK瓣部分脱位及前房积血。LASIK瓣重新复位，但恢复过程因上皮缺损愈合缓慢和瓣水肿而复杂化。受伤后1个月，发现LASIK瓣下有上皮内生。进行了瓣的手术掀起并清除上皮内生。8个月后，上皮内生消失，视力为20/40。残余不规则散光需要佩戴硬性透气性角膜接触镜以达到20/20的视力。
安全气囊可能导致严重的眼外伤。LASIK的伤口愈合反应使角膜瓣在术后一段不确定的时间内可与其基质床分离。在LASIK术前作为知情同意的一部分讨论角膜外伤的可能风险或许是合适的。
