Mandelbaum S, Waring G O, Forster R K, Culbertson W W, Rowsey J J, Espinal M E
Arch Ophthalmol. 1986 Aug;104(8):1156-60. doi: 10.1001/archopht.1986.01050200062050.
We describe three patients in whom ulcerative keratitis developed seven months to 2 1/2 years after uncomplicated radial keratotomy. All ulcers occurred along keratotomy scars within the interpalpebral fissure or inferiorly. At least one case developed spontaneously; another patient may have sustained an unrecognized corneal injury. The third patient was using an extended-wear soft contact lens for correction of residual myopia. Bacteria were isolated from two of the ulcers. With therapy, all ulcers healed without reducing visual acuity. We hypothesize that the altered structure of the slowly healing keratotomy incisions coupled with redistribution of the tear film due to changes in corneal topography may result in intermittent epithelial irregularities. Alone or in conjunction with any form of mechanical or hypoxic corneal injury, these changes along keratotomy incisions may predispose to corneal infection.
我们描述了3例患者，他们在无并发症的放射状角膜切开术后7个月至2年半发生了溃疡性角膜炎。所有溃疡均发生在睑裂间或下方的角膜切开瘢痕处。至少有1例是自发发生的；另一例患者可能遭受了未被识别的角膜损伤。第3例患者正在使用长戴型软性接触镜来矫正残余近视。从其中2例溃疡中分离出了细菌。经过治疗，所有溃疡均愈合，视力未下降。我们推测，愈合缓慢的角膜切开切口结构改变，加上角膜地形图变化导致泪膜重新分布，可能会导致间歇性上皮不规则。这些角膜切开切口处的变化单独或与任何形式的机械性或低氧性角膜损伤共同作用，可能易引发角膜感染。
