Brilakis Harilaos S, Holland Edward J
University of Cincinnati & Cincinnati Eye Institute, Cincinnati, Ohio 45242, USA.
J Refract Surg. 2006 Jan-Feb;22(1):103-5. doi: 10.3928/1081-597X-20060101-20.
To describe anterior stromal puncture, with or without a bandage contact lens, as a means to treat LASIK epithelial defects and potentially reduce the likelihood of secondary diffuse lamellar keratitis (DLK).
Six eyes of five LASIK patients had their microkeratome pass complicated by loose epithelium, central in one case. After repositioning the flap, a 25-gauge needle on a tuberculin syringe was used to puncture the anterior corneal stroma to just beneath Bowman's layer in the affected area of irregular epithelium. A bandage contact lens was placed on two eyes, including the one with loose epithelium centrally.
Normal appearance of the corneal epithelium was noted by postoperative day 1; no eye developed DLK or significant epithelial ingrowth postoperatively. All eyes achieved > or = 20/20 vision.
By obviating, in select cases, the need for bandage contact lenses, anterior stromal puncture could increase patient comfort and remove a potential source of infection.
描述前弹力层下穿刺术（无论是否联合使用绷带式角膜接触镜）作为治疗准分子激光原位角膜磨镶术（LASIK）上皮缺损并可能降低继发性弥漫性板层角膜炎（DLK）发生可能性的一种方法。
5例LASIK患者的6只眼在微型角膜刀制瓣过程中出现上皮松解，其中1例为中央部上皮松解。在将瓣复位后，用结核菌素注射器上的25号针头在不规则上皮的受累区域穿刺前弹力层下的角膜基质。2只眼放置了绷带式角膜接触镜，其中包括1例中央部上皮松解的患眼。
术后第1天角膜上皮外观正常；术后无眼发生DLK或明显的上皮内生。所有眼均达到≥20/20的视力。
在某些情况下，前弹力层下穿刺术无需使用绷带式角膜接触镜，可提高患者舒适度并消除潜在的感染源。
