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激光辅助原位角膜磨镶术的过敏并发症。

Allergic complications with laser-assisted in-situ keratomileusis.

机构信息

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami - Miller School of Medicine, Palm Beach Gardens, Florida, USA.

出版信息

Curr Opin Allergy Clin Immunol. 2011 Oct;11(5):483-91. doi: 10.1097/ACI.0b013e32834a4e01.

DOI:10.1097/ACI.0b013e32834a4e01
PMID:21822133
Abstract

PURPOSE OF REVIEW

This article reviews the complications of laser-assisted in-situ keratomileusis (LASIK) associated with ocular allergy. This review will provide guidance and heighten the need for a more comprehensive allergic evaluation before recommending LASIK procedure to patients. The material provided allows enhanced awareness of the potential postsurgical effects on allergic responses of the ocular surface and management thereof.

RECENT FINDINGS

Ocular allergy is often underdiagnosed and has been previously reported only in a handful of peer-reviewed journals as the cause for ocular irritation and visual morbidity in post-LASIK dry eye disease. Diffuse lamellar keratitis is one complication of LASIK that has been linked to atopic individuals. LASIK causes significant inflammation in normal eyes, which is only exacerbated in atopic patients. Atopy may be a contributing factor in patients with patients with post-LASIK dry eye symptoms. Further investigation is required to better understand the complications of LASIK in allergic patients.

SUMMARY

LASIK surgery has been associated with increased anterior surface inflammatory processes that include dry eye syndromes and ocular allergy. In addition, poorer outcomes of LASIK procedures have been reported in patients with moderate to severe ocular allergies and chronic forms of allergic conjunctivitis, which is an absolute contraindication to the LASIK procedure. We propose preoperative and postoperative management algorithms for allergic LASIK candidates.

摘要

目的综述

本文综述了与眼部过敏相关的激光辅助原位角膜磨镶术(LASIK)的并发症。这篇综述将为患者推荐 LASIK 手术前提供指导和增强更全面的过敏评估的必要性。所提供的材料使人们更加了解潜在的术后对眼表过敏反应的影响及其管理。

最近的发现

眼部过敏经常被漏诊,之前仅在少数同行评审期刊中报道过,是 LASIK 术后干眼症导致眼部刺激和视力受损的原因。弥漫性层状角膜炎是 LASIK 的一种并发症,与特应性个体有关。LASIK 会导致正常眼睛发生明显炎症,而在特应性患者中则会加重炎症。特应性可能是 LASIK 术后干眼症患者的一个致病因素。需要进一步研究以更好地了解过敏患者的 LASIK 并发症。

总结

LASIK 手术与包括干眼症综合征和眼部过敏在内的前表面炎症过程增加有关。此外,在中度至重度眼部过敏和慢性过敏性结膜炎患者中,LASIK 手术的效果较差,这是 LASIK 手术的绝对禁忌症。我们为过敏的 LASIK 候选者提出了术前和术后管理算法。

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