Korn Bobby S, Kikkawa Don O, Schanzlin David J
La Jolla, Calif From the Divisions of Ophthalmic Plastic and Reconstructive Surgery and Cornea and Keratorefractive Surgery, Department of Ophthalmology, University of California, San Diego School of Medicine.
Plast Reconstr Surg. 2007 Jun;119(7):2232-2239. doi: 10.1097/01.prs.0000260750.15059.17.
The authors used a retrospective case series to describe the increased frequency of dry eye syndrome in patients who have undergone both laser in situ keratomileusis and blepharoplasty.
The authors reviewed records from six patients who required surgical correction for exposure keratopathy previously treated by both laser in situ keratomileusis and blepharoplasty.
All six patients developed significant exposure keratopathy postoperatively requiring surgical intervention. Four patients had blepharoplasty followed by laser in situ keratomileusis, and two patients had laser in situ keratomileusis followed by blepharoplasty. Symptomatic dry eye symptoms followed the second procedure 1 week to 4 months later. Surgical correction of eyelid malposition and lagophthalmos markedly improved symptoms.
Patients with a history of laser in situ keratomileusis contemplating blepharoplasty are at higher risk of developing postoperative dry eye syndrome. Surgeons performing these procedures should perform thorough preoperative evaluation and surgical planning to minimize this potential complication.
作者采用回顾性病例系列研究，描述接受准分子原位角膜磨镶术（LASIK）和眼睑成形术的患者干眼综合征发生率增加的情况。
作者回顾了6例因暴露性角膜病变接受手术矫正的患者的记录，这些患者之前均接受过准分子原位角膜磨镶术和眼睑成形术。
所有6例患者术后均出现严重的暴露性角膜病变，需要手术干预。4例患者先接受了眼睑成形术，然后进行准分子原位角膜磨镶术，2例患者先进行准分子原位角膜磨镶术，然后进行眼睑成形术。有症状的干眼症状在第二次手术后1周 至4个月出现。眼睑位置异常和兔眼的手术矫正显著改善了症状。
有准分子原位角膜磨镶术病史且考虑行眼睑成形术的患者发生术后干眼综合征的风险更高。实施这些手术的外科医生应进行全面的术前评估和手术规划，以尽量减少这种潜在并发症。
