Banning Christopher S, Larson Paul M, Randleman J Bradley
Department of Ophthalmology, Emory University, Atlanta, GA, USA.
Cornea. 2006 Dec;25(10):1262-4. doi: 10.1097/01.ico.0000230345.64607.8a.
To report the outcome of laser in situ keratomileusis (LASIK) in a patient with Fleck corneal dystrophy.
Case report and literature review.
A 48-year-old Taiwanese man presented in November 2005, 6 years after bilateral myopic LASIK. He complained of loss of uncorrected distance visual acuity that was worse in the left eye. The patient did not report glare, halos, or other visual aberrations. Preoperative best spectacle-corrected visual acuity (BSCVA) was 20/25 OU, with a manifest refraction of -14 D OU. In November 2005, uncorrected visual acuity (UCVA) was 20/40 OD and 20/50 OS, and BSCVA was 20/25 in each eye with a manifest refraction of -1.00 sphere OD and -1.75 -1.25 x 115 OS. Slit-lamp examination was remarkable for several subtle, small, gray corneal opacities present throughout the corneal stroma. Confocal microscopy revealed refractile bodies within swollen keratocytes and normal surrounding stromal mileu. The clinical and confocal appearance was consistent with Fleck corneal dystrophy.
In this patient with Fleck corneal dystrophy, corneal clarity and BSCVA were maintained 6 years after bilateral myopic LASIK, suggesting that LASIK does not stimulate visually significant exacerbation of Fleck corneal dystrophy.
报告1例斑点状角膜营养不良患者行准分子原位角膜磨镶术(LASIK)的结果。
病例报告及文献复习。
一名48岁的台湾男性于2005年11月就诊,此时距双眼近视性LASIK手术已过去6年。他主诉未矫正的远视力下降,左眼更严重。患者未报告眩光、光晕或其他视觉像差。术前最佳矫正视力(BSCVA)为双眼20/25,明显屈光不正为双眼-14D。2005年11月,未矫正视力(UCVA)右眼为20/40,左眼为20/50,每眼的BSCVA均为20/25,明显屈光不正为右眼-1.00球镜,左眼-1.75 -1.25×115。裂隙灯检查发现角膜基质层有多个细微、小的灰色角膜混浊。共焦显微镜检查显示肿胀的角膜细胞内有折光体,周围基质环境正常。临床和共焦显微镜表现符合斑点状角膜营养不良。
在该斑点状角膜营养不良患者中,双眼近视性LASIK术后6年角膜清晰度和BSCVA得以维持,提示LASIK不会刺激斑点状角膜营养不良出现明显的视觉恶化。