de Oliveira Giselle C, Solari Helena P, Ciola Fabiano B, Lima Ana Luisa Höfling, Campos Mauro S
Sector of Refractive Surgery, Department of Ophthalmology, Federal University of São Paulo, Paulista School of Medicine, São Paulo, Brazil.
J Refract Surg. 2006 Feb;22(2):159-65. doi: 10.3928/1081-597X-20060201-14.
To determine the frequency and clinical characteristics of corneal infiltrates after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) and to evaluate the efficacy of treatment.
We retrospectively reviewed the records of 8508 eyes treated with PRK or LASIK in a university-based clinic for the correction of refractive errors for 60 days postoperatively.
Corneal infiltrates were observed in 35 (0.8%) of 4492 PRK-operated eyes and in 4 (0.1%) of 4016 LASIK-operated eyes. The mean time of diagnosis was 5.46 days. Among the 39 eyes with infiltrates, 10 (9 PRK, 1 LASIK) had culture-verified infectious keratitis. Coagulase-negative Staphylococcus was the most frequently isolated bacterium (50%), followed by S aureus (20%), Corynebacterium xerosis (10%), Streptococcus viridans (10%), and an unidentified gram-positive coccus (10%). Final visual acuity of > or = 20/30, without correction, was achieved in 79.5% of the 39 eyes.
Corneal infiltrates occurred in 0.8% of PRK eyes and 0.1% of LASIK eyes. Bacterial smears were positive for several eyes. In all cases, prompt treatment was responsible for good visual outcome.
确定准分子原位角膜磨镶术(PRK)和准分子激光原位角膜磨镶术(LASIK)后角膜浸润的发生率及临床特征,并评估治疗效果。
我们回顾性分析了一所大学诊所8508只接受PRK或LASIK治疗以矫正屈光不正的眼睛术后60天的记录。
4492只接受PRK手术的眼睛中有35只(0.8%)出现角膜浸润,4016只接受LASIK手术的眼睛中有4只(0.1%)出现角膜浸润。诊断的平均时间为5.46天。在39只有浸润的眼睛中,10只(9只PRK,1只LASIK)经培养证实为感染性角膜炎。凝固酶阴性葡萄球菌是最常分离出的细菌(50%),其次是金黄色葡萄球菌(20%)、干燥棒状杆菌(10%)、草绿色链球菌(10%)和一种未鉴定的革兰氏阳性球菌(10%)。39只眼中79.5%的眼睛最终视力在未矫正的情况下达到或优于20/30。
PRK术后眼睛角膜浸润发生率为0.8%,LASIK术后为0.1%。几只眼睛的细菌涂片呈阳性。在所有病例中,及时治疗带来了良好的视力结果。