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阿韦利诺角膜营养不良患者LASIK术后的撒哈拉沙漠沙粒样改变。

Sands of sahara after LASIK in avellino corneal dystrophy.

作者信息

Mantelli Flavio, Lambiase Alessandro, Di Zazzo Antonio, Bonini Stefano

机构信息

Department of Ophthalmology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 21, 00128 Rome, Italy.

出版信息

Case Rep Ophthalmol Med. 2012;2012:413010. doi: 10.1155/2012/413010. Epub 2012 Feb 2.

Abstract

We report the case of a patient diagnosed with Avellino corneal dystrophy (ACD) who developed diffuse interstitial keratitis following excimer laser insitu keratomileusis (LASIK). ACD is an autosomal dominant corneal dystrophy characterized by multiple asymmetric stromal opacities that impair vision. Accepted treatments for this condition include corneal transplantation and phototherapeutic keratectomy (PTK). Our patient underwent LASIK at another institution to correct myopia. LASIK and photorefractive keratectomy (PRK) are usually contraindicated in ACD for the high risk of disease recurrence and postoperative complications. The patient came to our attention lamenting blurry vision, decreased visual acuity, and photophobia. Ophthalmologic examination revealed bilateral interstitial keratitis, also known as "sands of Sahara", a seldom-seen complication of LASIK characterized by fine and diffuse granular infiltrates at the surgical flap interface.The risk of developing interstitial keratitis, as in the case presented here, represents another valid reason for avoiding LASIK in patients with ACD.

摘要

我们报告了一例被诊断为阿韦利诺角膜营养不良(ACD)的患者,该患者在准分子激光原位角膜磨镶术(LASIK)后发生了弥漫性间质性角膜炎。ACD是一种常染色体显性遗传性角膜营养不良,其特征为多个不对称的基质混浊,会损害视力。针对这种病症的公认治疗方法包括角膜移植和光治疗性角膜切除术(PTK)。我们的患者在另一家机构接受了LASIK手术以矫正近视。由于疾病复发和术后并发症的高风险,LASIK和光性屈光性角膜切削术(PRK)通常在ACD患者中被视为禁忌。该患者因视力模糊、视力下降和畏光前来就诊。眼科检查发现双侧间质性角膜炎,也称为“撒哈拉沙漠之沙”,这是一种LASIK少见的并发症,其特征是在手术瓣界面处有细小且弥漫性的颗粒状浸润。如本病例所示,发生间质性角膜炎的风险是在ACD患者中避免进行LASIK的另一个合理原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a069/3350253/34ab79f01d22/CRIM.OPHMED2012-413010.001.jpg

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