准分子激光原位角膜磨镶术后因类固醇诱导的眼压升高导致的早期短暂视力丧失。
Early transient visual acuity loss after LASIK due to steroid-induced elevation of intraocular pressure.
作者信息
Frucht-Pery Joseph, Landau David, Raiskup Frederik, Orucov Faik, Strassman Eyal, Blumenthal Eytan Z, Solomon Abraham
机构信息
Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
出版信息
J Refract Surg. 2007 Mar;23(3):244-51. doi: 10.3928/1081-597X-20070301-06.
PURPOSE
To report the clinical course of early transient reduction of uncorrected visual acuity (UCVA) after LASIK surgery resulting from steroid-induced elevation of intraocular pressure (IOP).
METHODS
Twenty-nine eyes of 15 patients who received topical corticosteroids after uneventful myopic LASIK surgery and had a decrease in UCVA within the first 3 weeks were evaluated retrospectively.
RESULTS
Intraocular pressure increased by 4 to 30 mmHg from preoperative to postoperative days 4 to 20. Twenty-seven of 29 eyes had a decrease in UCVA and/or best spectacle-corrected visual acuity (BSCVA). All eyes, except one, had edema without evidence of inflammation in the interface or the remainder of the cornea. Discontinuation of topical corticosteroids and application of anti-glaucoma medications resulted in a decrease of IOP to normal levels, reduction or disappearance of the edema, and recovery of BSCVA.
CONCLUSIONS
Early onset steroid-induced elevation of IOP after LASIK may cause corneal edema and a sudden decrease in UCVA. Rapid diagnosis and treatment can control IOP and recover the visual loss.
目的
报告准分子原位角膜磨镶术（LASIK）术后因类固醇诱导的眼压（IOP）升高导致未矫正视力（UCVA）早期短暂下降的临床过程。
方法
回顾性评估15例患者的29只眼，这些患者在近视LASIK手术顺利完成后接受了局部皮质类固醇治疗，并在术后3周内出现UCVA下降。
结果
从术前到术后第4至20天，眼压升高了4至30 mmHg。29只眼中的27只眼的UCVA和/或最佳矫正视力（BSCVA）下降。除一只眼外，所有眼睛均出现水肿，在角膜瓣界面或角膜其余部分未发现炎症迹象。停用局部皮质类固醇并应用抗青光眼药物后，眼压降至正常水平，水肿减轻或消失，BSCVA恢复。
结论
LASIK术后早期发生的类固醇诱导的眼压升高可能导致角膜水肿和UCVA突然下降。快速诊断和治疗可控制眼压并恢复视力丧失。
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