Moshirfar Majid, Fuhriman David A, Ali Amir, Odayar Varshini, Ronquillo Yasmyne C, Hoopes Phillip C
Hoopes Vision Research Center, Hoopes Vision, 11820 S. State St., Ste. 200, Draper, UT 84020, USA.
John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT 84132-2101, USA.
J Clin Med. 2022 Aug 19;11(16):4861. doi: 10.3390/jcm11164861.
Inflammatory bowel disease (IBD) is a chronic systemic inflammatory condition that can potentially adversely affect surgical outcomes in patients receiving elective ophthalmic procedures. In this case series, 21 eyes of 11 patients with ulcerative colitis or Crohn's disease underwent laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), or small incision lenticule extraction (SMILE). Their surgical outcomes were followed up for an average of 8.9 ± 4.6 months. All the patients in this study did well, with 100% of eyes corrected for distance vision achieving uncorrected distance visual acuity 20/20 by postoperative month three. Common symptoms noted during the postoperative period included dry eyes, irritation, foreign body sensation, and blurry vision, all of which improved in prevalence and severity over the follow-up period, and none of the patients experienced a flare-up of their disease. Despite the successful outcomes in these patients, the authors recognize the inherent risks of operating on patients with IBD. Currently, there are no consensus guidelines for clinicians to follow to ensure that they are adequately screening these patients for eligibility, so the authors are suggesting a relevant, focused review of systems, a brief IBD history-related questionnaire, and a preliminary surgical decision-making flowchart for use in surgical evaluation.
炎症性肠病（IBD）是一种慢性全身性炎症性疾病，可能会对接受择期眼科手术患者的手术结果产生潜在的不利影响。在这个病例系列中，11例溃疡性结肠炎或克罗恩病患者的21只眼睛接受了准分子原位角膜磨镶术（LASIK）、准分子激光角膜切削术（PRK）或小切口基质透镜切除术（SMILE）。对他们的手术结果进行了平均8.9±4.6个月的随访。本研究中的所有患者情况良好，到术后第三个月，100%的矫正远视力眼达到了20/20的未矫正远视力。术后常见症状包括干眼感、刺激感、异物感和视力模糊，所有这些症状在随访期间的发生率和严重程度均有所改善，且没有患者出现病情复发。尽管这些患者取得了成功的手术结果，但作者认识到对IBD患者进行手术存在内在风险。目前，对于临床医生而言，尚无共识性指南可供遵循以确保他们对这些患者进行充分的资格筛查，因此作者建议在手术评估中使用相关的、有针对性的系统回顾、一份与IBD病史相关的简短问卷以及一份初步的手术决策流程图。
