Marmer R H
Morehouse University School of Medicine, Atlanta, Georgia.
Ann Ophthalmol. 1987 Nov;19(11):409-11.
In a new surgical procedure, adverse reactions or complications may surface without most ophthalmic surgeons experiencing them or being aware of them. Even those with a large series of cases may never see certain problems. Through a collaborative effort with over 200 radial keratotomy surgeons totaling 63,000 cases nearly every significant complication has been documented. This study of radial keratotomy complications includes the number of patients and percentage of the total of the following: intraoperative occurrences which generally do not affect vision, which include microperforations and macroperforations; postoperative changes which do not affect vision: limbal "peeking" and star pattern with light; transient occurrences which tend to resolve with time: ptosis, recurrent erosions, corneal ulcer, microwound abscess, delayed wound healing, inferior rectus palsy, glare or fluctuating vision after six months, iritis, and stromal keratitis; postoperative changes which can affect vision (correctible): overcorrection more than 1.5 diopters, marked undercorrection more than -2.00 diopters, irregular astigmatism, neovascularization after soft-contact-lens wear, and best-corrected acuity decreased usually only one line; and postoperative changes which can affect vision (uncorrectible): retrobulbar hemorrhage and endophthalmitis, loss of the eye, herpes keratitis, and cataract formation.
在一种新的外科手术中，不良反应或并发症可能会出现，而大多数眼科外科医生并未经历过或意识到这些情况。即使是那些处理过大量病例的医生，也可能从未见过某些问题。通过与200多位放射状角膜切开术外科医生合作，共计63000例病例，几乎每一种重大并发症都有记录。这项关于放射状角膜切开术并发症的研究涵盖了患者数量以及以下各项在总数中所占的百分比：通常不影响视力的术中情况，包括微小穿孔和大穿孔；不影响视力的术后变化：角膜缘“窥视”和光线下的星状图案；随时间推移往往会自行缓解的短暂情况：上睑下垂、复发性角膜糜烂、角膜溃疡、微小伤口脓肿、伤口愈合延迟、下直肌麻痹、六个月后眩光或视力波动、虹膜炎和基质性角膜炎；可影响视力（可矫正）的术后变化：超过1.5屈光度的过矫、超过 -2.00屈光度的明显欠矫、不规则散光、软性接触镜佩戴后新生血管形成，以及最佳矫正视力通常仅下降一行；以及可影响视力（不可矫正）的术后变化：球后出血和眼内炎、眼球丧失、疱疹性角膜炎和白内障形成。
