Antonios Rafic, Jabbur Nada S, Ahmed Mohammed A, Awwad Shady T
Department of Ophthalmology, American University of Beirut, Lebanon.
Department of Ophthalmology, Clemenceau Medical Center, Lebanon.
Am J Ophthalmol Case Rep. 2018 Jan 28;10:10-12. doi: 10.1016/j.ajoc.2018.01.034. eCollection 2018 Jun.
To report the occurrence and the management of refractory interface haze that developed after epithelial ingrowth following small aperture inlay implantation.
A 52 year-old man with sub-clinical anterior basement membrane dystrophy (ABMD) underwent combined hyperopic laser in situ keratomileusis and KAMRA corneal inlay implantation to correct presbyopia. Post-operatively, epithelial ingrowth developed requiring debridement and KAMRA removal. Significant diffuse interface haze, ground-glass in texture, involving the central 6 mm of the cornea developed the next day, and was refractory to topical and systemic steroids, necessitating flap irrigation, gentle scraping, and MMC application to the residual stromal bed after 12 days. The interface haze gradually improved to near complete resolution over 12-months.
Epithelial ingrowth can lead to flap interface haze refractory to medical therapy. Early surgical intervention is key to haze resolution.
报告小孔镶嵌植入术后上皮内生后出现的难治性界面混浊及其处理方法。
一名患有亚临床前弹力层基底膜营养不良（ABMD）的52岁男性接受了远视准分子原位角膜磨镶术联合KAMRA角膜镶嵌植入术以矫正老花眼。术后出现上皮内生，需要进行清创和取出KAMRA。术后第二天，角膜中央6mm区域出现了明显的弥漫性界面混浊，质地如磨砂玻璃，对局部和全身使用类固醇药物均无反应，12天后需要对角膜瓣进行冲洗、轻柔刮擦，并在残留基质床上应用丝裂霉素C。界面混浊在12个月内逐渐改善，几乎完全消退。
上皮内生可导致瓣界面混浊，药物治疗无效。早期手术干预是解决混浊的关键。
