Roszkowska Anna M, Oliverio Giovanni W, Signorino Giuseppe A, Urso Mario, Aragona Pasquale
Ophthalmology Unit, Department of Biomedical Sciences, University Hospital of Messina, Messina, Italy.
Case Rep Ophthalmol. 2021 Jun 11;12(2):492-496. doi: 10.1159/000516311. eCollection 2021 May-Aug.
We report long-term alterations of anterior corneal stroma after excimer laser surface ablation for a high astigmatism. The patient claimed progressive visual loss in his right eye (RE) during the last 3 years after bilateral laser-assisted subepithelial keratectomy (LASEK) surgery. His examination comprised visual acuity (UDVA and CDVA), slit-lamp examination, corneal topography and tomography, AS-OCT, and confocal microscopy. The UDVA was 0.1 in his RE and 1.0 in the left eye. The CDVA in the RE was 0.8. The slit-lamp examination showed a stromal lesion in the inferior paracentral corneal zone, with multiple vertical tissue bridges and severe thinning. Corneal topography and tomography showed central flattening with inferior steepening and severe alteration in elevation maps. AS-OCT showed void areas in the anterior stroma with thinning of the underlying tissue, and confocal images were not specific. In this case, progressive corneal steepening and thinning that manifest topographically as inferior ectasia occurred in correspondence to the singular stromal alterations after LASEK.
我们报告了准分子激光表面消融治疗高度散光后角膜前基质的长期变化。该患者称，在双眼激光辅助上皮下角膜磨镶术（LASEK）手术后的最后3年里，右眼（RE）视力逐渐下降。他的检查包括视力（裸眼视力和矫正视力）、裂隙灯检查、角膜地形图和断层扫描、眼前节光学相干断层扫描（AS-OCT）以及共焦显微镜检查。其右眼裸眼视力为0.1，左眼为1.0。右眼矫正视力为0.8。裂隙灯检查显示角膜中央旁下方区域有基质病变，有多个垂直的组织桥且严重变薄。角膜地形图和断层扫描显示中央变平，下方变陡，高度图有严重改变。眼前节光学相干断层扫描显示前基质有空虚区域，其下方组织变薄，共焦图像不具有特异性。在这种情况下，LASEK术后独特的基质改变对应出现了角膜逐渐变陡和变薄，在地形图上表现为下方角膜扩张。
