Handzel D M, Stanzel B V, Briesen S
Augenklinik Dardenne, Friedrich-Ebert-Str. 23-25, 53177, Bonn, Deutschland.
Ophthalmologe. 2011 Jul;108(7):665-8. doi: 10.1007/s00347-011-2347-4.
This report concerns the case of a 28-year-old female patient who was treated with topical steroids for 2 years following complicated hyperopic LASIK surgery with a re-treatment including a re-lift of the flap. A steroid-induced rise in the intraocular pressure (IOP) was subsequently observed on the treated eye, together with a glaucomatous subtotal destruction of the optic nerve, resulting in a residual vision of 1/15. An erroneously low IOP measurement, which was probably the reason for the delay in detecting steroid-induced glaucoma, has been reported in several cases concerning LASIK patients. The reason for the unusually severe course in the case in question can only be presumed, namely a possible accumulation of fluid at the interface or altered biomechanics following hyperopic LASIK surgery. The need for a thorough postoperative examination following refractive surgery must be emphasized. This case shows a cascade of complications following hyperopic LASIK surgery resulting in the functional blindness of one eye.
本报告涉及一名28岁女性患者的病例，该患者在复杂远视性准分子激光原位角膜磨镶术（LASIK）后接受了2年的局部类固醇治疗，再次治疗包括重新掀起角膜瓣。随后在治疗眼观察到类固醇诱导的眼压（IOP）升高，以及青光眼导致的视神经部分破坏，导致残余视力为1/15。在几例关于LASIK患者的病例中都报告了错误的低眼压测量，这可能是检测类固醇诱导性青光眼延迟的原因。对于该病例中异常严重病程的原因只能进行推测，即远视性LASIK手术后界面处可能存在液体积聚或生物力学改变。必须强调屈光手术后进行全面术后检查的必要性。该病例显示了远视性LASIK手术后一系列并发症，导致一只眼睛功能性失明。
