Linke S J, Richard G, Katz T
Universitätsklinikum Eppendorf, Klinik und Poliklinik für Augenheilkunde, Martinistrasse 52, Hamburg.
Klin Monbl Augenheilkd. 2011 Jun;228(6):531-6. doi: 10.1055/s-0029-1245549. Epub 2010 Nov 24.
LASIK has become the preferred surgical procedure for the correction of refractive errors. Microbial keratitis is a rare but severe complication. The incidence of post-LASIK keratitis, (uni- and bilateral) is difficult to estimate. The risk of bilateral infection could until now only be approximated by calculating it from the risk of unilateral infection. Due to the fortunately low incidence of post-LASIK keratitis, large-scale studies are necessary to obtain valid statistical data. The American Society of Cataract and Refractive surgery (ASCRS) developed a post-LASIK infectious keratitis survey in 2001. 116 post-LASIK infections were reported by the members of the society. The calculated incidence was 0.035 % or 1 infection in every 2919 procedures. Llovet et al. found 9 patients (18 eyes) with bilateral post-LASIK keratitis out of 204 586 procedures (incidence 0.0084 %). Gram-positive bacteria and atypical mycobacteria are the most common causes for microbial post-LASIK keratitis. There is an increasing literature of post-LASIK case reports caused by rare or atypical species. Severe cases of keratitis are more often correlated with a prolonged onset of infection and caused by atypical species. An overview of the current literature and our own data regarding post-LASIK keratitis (uni-, and bilateral) are presented.
准分子激光原位角膜磨镶术(LASIK)已成为矫正屈光不正的首选外科手术。微生物性角膜炎是一种罕见但严重的并发症。LASIK术后角膜炎(单侧和双侧)的发病率难以估计。迄今为止,双侧感染的风险只能通过根据单侧感染的风险进行计算来近似估算。由于LASIK术后角膜炎的发病率幸运地较低,因此需要进行大规模研究以获得有效的统计数据。美国白内障和屈光手术学会(ASCRS)在2001年开展了一项LASIK术后感染性角膜炎调查。该学会成员报告了116例LASIK术后感染病例。计算出的发病率为0.035%,即每2919例手术中有1例感染。洛维特等人在204586例手术中发现9例(18只眼)双侧LASIK术后角膜炎患者(发病率0.0084%)。革兰氏阳性菌和非典型分枝杆菌是微生物性LASIK术后角膜炎最常见的病因。由罕见或非典型菌种引起的LASIK术后病例报告的文献越来越多。严重的角膜炎病例更常与感染发作时间延长相关,且由非典型菌种引起。本文介绍了有关LASIK术后角膜炎(单侧和双侧)的当前文献及我们自己的数据的综述。