Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
JAMA Ophthalmol. 2013 Aug;131(8):1070-2. doi: 10.1001/jamaophthalmol.2013.1738.
Pressure-induced stromal keratopathy is a rare kind of complication of laser in situ keratomileusis (LASIK) that may cause vision loss in affected eyes. Herein, we described the clinical features and treatment of 2 cases of pressure-induced stromal keratopathy due to traumatic hyphema in post-LASIK eyes.
Two patients sought treatment for painful vision loss after blunt trauma on post-LASIK eyes. On examination, high intraocular pressure was found in the injured eyes. Hyphema was seen in the anterior chamber. High-resolution slitlamp biomicroscopy demonstrated interface hyperreflection, which resembled interface keratitis. However, an isolated pocket of fluid was clearly demonstrated at the level of the LASIK flap interface in the anterior segment optical coherence tomographic images. After topical corticosteroid and antiglaucoma medication, the hyphema and the hyperreflection in the cornea resolved in several days. The intraocular pressure and visual acuity returned to normal levels. Repeated anterior segment optical coherence tomographic examinations revealed completed resolution of the interface fluid.
To our knowledge, this is the first report of pressure-induced stromal keratopathy caused by traumatic hyphema. Anterior segment optical coherence tomography plays a unique role in revealing occult interface fluid in post-LASIK eyes, which may masquerade as interface keratitis during slitlamp examination.
压力诱导性基质角膜炎是 LASIK（准分子激光原位角膜磨镶术）后一种罕见的并发症，可能导致受影响眼睛的视力丧失。在此，我们描述了 2 例因 LASIK 后创伤性前房积血引起的压力诱导性基质角膜炎的临床特征和治疗方法。
2 名患者因 LASIK 后眼钝挫伤寻求治疗，出现视力丧失伴疼痛。检查发现受伤眼眼压高。前房可见血。高分辨率裂隙灯生物显微镜显示界面高反射，类似于界面性角膜炎。然而，在前节光学相干断层扫描图像中，LASIK 瓣界面水平清楚地显示出一个孤立的液袋。局部皮质类固醇和抗青光眼药物治疗数天后，角膜中的积血和高反射消失。眼压和视力恢复正常水平。重复前节光学相干断层扫描检查显示界面液完全吸收。
据我们所知，这是首例由创伤性前房积血引起的压力诱导性基质角膜炎的报告。前节光学相干断层扫描在揭示 LASIK 后隐匿性界面液方面发挥着独特的作用，在裂隙灯检查中可能被误诊为界面性角膜炎。
