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人类白细胞抗原-B27阳性患者行准分子原位角膜磨镶术后发生葡萄膜炎的风险。

Risk for uveitis after laser in situ keratomileusis in patients positive for human leukocyte antigen-B27.

作者信息

Moshirfar Majid, Siddharthan K S, Meyer Jay J, Espandar Ladan, Wolsey Darcy H, Vitale Albert T

机构信息

Department of Ophthalmology and Visual Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah 84132, USA.

出版信息

J Cataract Refract Surg. 2008 Jul;34(7):1110-3. doi: 10.1016/j.jcrs.2008.03.016.

Abstract

PURPOSE

To assess the incidence of, risk for, and visual outcomes of acute anterior uveitis (AAU) in human leukocyte antigen (HLA)-B27 positive patients who had laser in situ keratomileusis (LASIK).

SETTING

University-based center.

METHODS

This study comprised 46 eyes of 23 HLA-B27 positive patients with a 5-year follow-up. Data on episodes of uveitis were reviewed retrospectively and the incidence rates calculated for LASIK and non-LASIK eyes. Kaplan-Meier survival probabilities were calculated for uveitis occurring during the final 36 to 60 months of the study. Survival probabilities between LASIK and non-LASIK eyes were compared.

RESULTS

Twenty eyes (10 patients) had LASIK a mean of 36 months+/-2 (SD) after the diagnosis of HLA-B27. In the HLA-B27 positive patients, the incidence rates of uveitis between eyes that had and eyes that did not have LASIK were not significantly different. The incidence rates of uveitis after LASIK did not differ significantly between eyes with and eyes without episodes of uveitis before LASIK (P=.135). The probability of an eye having no episode of uveitis in the fourth and fifth year of follow-up was not significantly different between eyes that had LASIK and those that did not (P=.668).

CONCLUSIONS

The occurrence rate of post-LASIK AAU in the HLA-B27 positive population was not higher than the general incidence in a similar HLA-B27 population without previous LASIK. A previous episode of uveitis did not appear to increase the risk for uveitis after LASIK in HLA-B27 positive patients.

摘要

目的

评估接受准分子原位角膜磨镶术(LASIK)的人类白细胞抗原(HLA)-B27阳性患者急性前葡萄膜炎(AAU)的发病率、风险及视力转归。

设置

大学附属医院。

方法

本研究纳入23例HLA-B27阳性患者的46只眼,随访5年。回顾性分析葡萄膜炎发作的数据,计算LASIK眼和非LASIK眼的发病率。计算研究最后36至60个月期间发生葡萄膜炎的Kaplan-Meier生存概率。比较LASIK眼和非LASIK眼的生存概率。

结果

20只眼(10例患者)在诊断为HLA-B27后平均36个月±2(标准差)接受了LASIK手术。在HLA-B27阳性患者中,接受LASIK手术的眼和未接受LASIK手术的眼之间葡萄膜炎的发病率无显著差异。LASIK术前有葡萄膜炎发作的眼和无葡萄膜炎发作的眼在LASIK术后葡萄膜炎的发病率无显著差异(P = 0.135)。在随访的第四年和第五年,接受LASIK手术的眼和未接受LASIK手术的眼无葡萄膜炎发作的概率无显著差异(P = 0.668)。

结论

HLA-B27阳性人群中LASIK术后AAU的发生率不高于未接受过LASIK手术的类似HLA-B27人群的总体发病率。既往葡萄膜炎发作似乎并未增加HLA-B27阳性患者LASIK术后葡萄膜炎的风险。

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