Cheng Clement J, Stark Walter J
Johns Hopkins University-Wilmer Eye Institute, Baltimore, Maryland 21287, USA.
J Cataract Refract Surg. 2007 Jul;33(7):1315-7. doi: 10.1016/j.jcrs.2007.03.026.
We report a case of cataract wound instability and subsequent management after cataract surgery in a patient who had had hyperopic laser in situ keratomileusis (LASIK). Standard cataract surgery was performed through a nasal limbal incision. One day postoperatively, the uncorrected visual acuity (UCVA) was 20/20 and the wound was stable. Subsequent examinations revealed overlying corneal edema, cataract wound slippage with corresponding with-the-rule astigmatism, and decreased vision. Separating and resuturing the cataract wound resulted in significant and stable improvement in the UCVA to 20/40. At 18 months, the best corrected visual acuity was 20/20 with a refraction of -3.50 +0.25x155 and keratometry of 44.75/45.00@155. Understanding wound stability and its management in cataract surgery in patients with prior LASIK refractive surgery will become increasingly important as more of these patients present.
我们报告了一例在接受过远视性准分子原位角膜磨镶术（LASIK）的患者中，白内障手术后出现白内障伤口不稳定及后续处理的病例。标准白内障手术通过鼻侧角膜缘切口进行。术后一天，裸眼视力（UCVA）为20/20，伤口稳定。随后的检查发现角膜上皮水肿、白内障伤口移位并伴有顺规散光，视力下降。分离并重新缝合白内障伤口后，裸眼视力显著且稳定地提高到了20/40。18个月时，最佳矫正视力为20/20，验光结果为-3.50 +0.25x155，角膜曲率计测量结果为44.75/45.00@155。随着越来越多此类患者前来就诊，了解既往接受过LASIK屈光手术患者白内障手术中伤口稳定性及其处理方法将变得越发重要。
