Department of Cornea & Refractive Surgery, Medical & Vision Research Foundation, Sankara Nethralaya, Chennai, India.
Cornea. 2012 May;31(5):575-80. doi: 10.1097/ICO.0b013e31821e42b2.
To report a case of unilateral post-laser-assisted in situ keratomileusis (LASIK) keratectasia in a 35-year-old woman who had no known predisposing risk factors but who rubbed her affected eye frequently and vigorously in response to allergic conjunctivitis.
Case report with relevant literature review.
A 35-year-old woman, with a cumulative risk scale score of 0 (according to the Randleman criteria), who underwent bilateral LASIK developed unilateral post-LASIK keratectasia 32 months later. She presented with a history of vigorous eye rubbing of the affected eye since about a year after allergic conjunctivitis. The fellow eye, which was not rubbed, remained normal. She complained of glare, halos, and ghost images in her affected eye. She underwent transepithelial topography-guided customized ablation with simultaneous UV-A corneal collagen cross-linking, after which she improved symptomatically and topographically.
Eye rubbing could contribute to the development of keratectasia, even in an eye that has no subclinical features of the disease. When detected early, a simultaneous combined topography-guided customized ablation treatment and collagen cross-linking is effective in improving the irregular corneal contour and restoring biomechanical stability.
报告一例 35 岁女性单侧 LASIK 术后角膜扩张症，该患者无已知的易患风险因素，但在过敏性结膜炎发作时频繁且剧烈地揉擦患眼。
病例报告并结合相关文献复习。
一位 35 岁女性，双眼均行 LASIK，累积风险评分 0（根据 Randleman 标准），术后 32 个月发生单侧 LASIK 术后角膜扩张症。她在过敏性结膜炎发作约一年后开始频繁揉擦患眼，而对侧未揉擦的眼睛保持正常。她主诉患眼有眩光、光晕和重影。行经上皮角膜地形图引导的定制消融术，同时行紫外线 A 角膜胶原交联术，术后她的症状和地形图均有改善。
即使在没有疾病亚临床特征的眼睛中，揉眼也可能导致角膜扩张症的发生。早期发现时，联合行经上皮角膜地形图引导的定制消融术和胶原交联术可有效改善不规则的角膜轮廓，恢复生物力学稳定性。
