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小切口微透镜取出术后 3 年双侧角膜扩张:边缘性病例报告。

Bilateral Corneal Ectasia 3 Years After Small Incision Lenticule Extraction in a Borderline Case.

机构信息

Cornea and Refractive Surgery, Asociación Para Evitar la Ceguera en México, I.A.P. México City, México.

Clínica Oftalmologica García de Oteyza, Barcelona, España; and.

出版信息

Cornea. 2022 Mar 1;41(3):359-362. doi: 10.1097/ICO.0000000000002952.

Abstract

PURPOSE

The purpose of this study was to report a case of bilateral ectasia 3 years after small incision lenticule extraction (SMILE) in a patient with normal preoperative topography of the right eye and abnormal topography of the left eye.

METHODS

This study was a case report.

RESULTS

A 22-year-old man developed bilateral corneal ectasia after SMILE. The preoperative corneal topography of the right eye was unremarkable, with a minimum corneal thickness of 511 μm in the right eye, and the abnormal corneal topography of the left eye revealed a risk factor for developing ectasia, with a minimum corneal thickness of 514 μm in the left eye. The refractive error was -4.50 to 3.50 × 10 degrees in his right eye and -4.25 to 3.50 × 0 degrees in his left eye with a best-corrected visual acuity of 20/20. An uncomplicated SMILE was performed; after his last follow-up visit at 1 month, the patient was lost to follow-up for 3 years. After that time, he presented with visual loss with left predominance. Bilateral ectasia was diagnosed through corneal topography, and crosslinking was performed in both eyes.

CONCLUSIONS

There are a very few reports of corneal ectasia after SMILE with normal preoperative topography.

摘要

目的

本研究报告了 1 例双眼在 SMILE 术后 3 年发生扩张的病例,该患者右眼术前角膜地形正常,左眼异常。

方法

本研究为病例报告。

结果

1 名 22 岁男性在 SMILE 后出现双侧角膜扩张。右眼术前角膜地形正常,右眼最小角膜厚度为 511μm,左眼异常角膜地形存在扩张的风险因素,左眼最小角膜厚度为 514μm。右眼屈光度为-4.50 至 3.50×10 度,左眼为-4.25 至 3.50×0 度,最佳矫正视力均为 20/20。行无并发症的 SMILE 手术;末次随访 1 个月后,患者失访 3 年。此后,他出现左眼为主的视力下降。通过角膜地形图诊断为双侧扩张,并对双眼进行了交联。

结论

SMILE 术后有非常少的报道显示术前角膜地形正常而发生扩张。

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