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准分子激光上皮下角膜磨镶术后因滥用局部麻醉剂导致的环形角膜炎

Ring Keratitis From Topical Anesthetic Abuse After Laser Epithelial Keratomileusis.

作者信息

Mergen Burak, Ozdamar Akif, Sarici Ahmet Murat

机构信息

Department of Ophthalmology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.

出版信息

Eye Contact Lens. 2018 Sep;44 Suppl 1:S365-S367. doi: 10.1097/ICL.0000000000000433.

Abstract

A 28-year-old man underwent laser epithelial keratomileusis for the correction of myopia in both eyes. The patient subsequently had delayed corneal epithelial healing in both eyes and ring infiltrate in the left eye (LE). Corneal scrapings were obtained from the ocular surface and subjected to microscopic examination and culture. On identifying and preventing the use of topical proparacaine, the corneal epithelium healed in both eyes after the use of eye pressure patches. The ring infiltrate resolved in the patient's LE, leaving minor opacity at the inferior cornea. Refractive surgeons should consider the possibility of topical anesthetic abuse in cases of corneal ring infiltrates. The resulting prognosis can be excellent after the rapid removal of inciting agents and the application of appropriate treatments.

摘要

一名28岁男性接受了准分子激光上皮下角膜磨镶术来矫正双眼近视。该患者随后双眼角膜上皮愈合延迟,左眼出现环形浸润。从眼表获取角膜刮片并进行显微镜检查和培养。在识别并停用局部使用的丙美卡因后,使用眼压贴片后双眼角膜上皮愈合。患者左眼的环形浸润消退,角膜下方遗留轻微混浊。屈光手术医生在角膜环形浸润病例中应考虑局部麻醉药滥用的可能性。迅速去除诱因并应用适当治疗后,预后可能极佳。

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