From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico.
From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico.
J Cataract Refract Surg. 2018 Oct;44(10):1284-1290. doi: 10.1016/j.jcrs.2018.06.053. Epub 2018 Aug 11.
We present a series of 4 cases of pressure-induced stromal keratopathy after laser in situ keratomileusis (LASIK). Four patients (5 eyes) with previous LASIK presented for poor visual acuity and ocular pain because of ocular hypertension. At examination, all cases revealed corneal haze and a space filled with fluid between the surgical flap and the residual stroma. All cases were managed with topical hypotensive treatment and one of them was also treated with a valve drainage device. Topical steroids restriction was indicated in all cases. Intraocular pressure (IOP) was normalized in all cases with subsequent interface fluid resolution and significant improvement of vision in most cases. Early recognition and appropriate treatment for pressure-induced stromal keratopathy is essential to avoid complications associated with prolonged elevated IOP. It is extremely important to measure the IOP in the peripheral cornea because IOP in the central cornea can be incorrectly measured with the characteristic interface fluid developed in this entity.
我们报告了 4 例 LASIK 术后眼压升高导致的基质性角膜病变。4 例（5 只眼）既往行 LASIK 手术的患者因眼压升高而出现视力下降和眼部疼痛。检查发现所有病例均存在角膜混浊，手术瓣与剩余基质之间有空腔充满液体。所有病例均给予降眼压治疗，其中 1 例还使用了引流阀。所有病例均限制使用皮质类固醇。眼压在所有病例中均恢复正常，随后界面液吸收，大多数病例视力显著改善。早期识别和适当治疗眼压升高导致的基质性角膜病变对于避免与长期高眼压相关的并发症至关重要。非常重要的是要测量周边角膜的眼压，因为在该病变中，特征性的界面液会导致中央角膜眼压的测量不准确。
