Two-Year Outcome of a Patient Treated With Phototherapeutic Keratectomy and Autologous SMILE Lenticule Transplantation for Flap-Related Complications Following LASIK
Two-Year Outcome of a Patient Treated With Phototherapeutic Keratectomy and Autologous SMILE Lenticule Transplantation for Flap-Related Complications Following LASIK
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一名接受光疗性角膜切除术和自体 SMILE 微透镜移植治疗 LASIK 术后角膜瓣相关并发症的患者的两年结果
DOI：
10.3928/1081597x-20180130-01
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发表时间：
2018
影响因子：
2.4
通讯作者：
Zhou Xingtao
中科院分区：
文献类型：
--
作者：
Zhao Jing;Zhao Feng;Huang Jinrong;Xu Haipeng;Chen Yingjun;Zhou Xingtao
目得：描述一名LASIK术后出现角膜瓣并发症的患者，该患者随后接受了激光治疗性角膜切除术（PTK）和通过小切口角膜摘出术（SMILE）获得的自体角膜移植。方法：一位23岁男性在接受LASIK手术后，左眼出现游离角膜瓣及部分角膜瓣缺失，导致角膜基质混浊。右眼的明显屈光度为-3.25屈光度球镜（DS）/-0.50屈光度柱镜（DC）× 100度，左眼为+2.50 DS/-1.25 DC × 155度。他的左眼用PTK治疗，并使用SMILE手术移植从他的右眼获得的自体晶状体。研究结果：在2年随访时，左眼的裸眼远视力从20/100提高到20/22，矫正远视力从20/25提高到20/18。中央角膜厚度从464 μ m增加到499 μ m。平均角膜曲率值从1个月随访访视时的45.00屈光度（D）降至2年随访访视时的39.40 D。光学相干断层扫描检查显示，小块仍然是透明的，并显示出可见的分界线。结论：通过SMILE联合PTK获得的自体角膜移植改善了LASIK术后角膜瓣丢失患者的裸眼视力和矫正视力。
PURPOSE: To describe a patient with flap complications after LASIK who was subsequently treated using phototherapeutic keratectomy (PTK) and an autologous lenticule transplant obtained via small incision lenticule extraction (SMILE). METHODS: A 23-year-old man experienced free flap and partial flap loss in the left eye following LASIK, resulting in corneal stroma opacity 1 month later. The manifest refraction was -3.25 diopters sphere (DS)/-0.50 diopters cylinder (DC) x 100 degrees in the right eye and +2.50 DS/-1.25 DC x 155 degrees in the left eye. His left eye was treated with PTK and transplantation of an autologous lenticule obtained from his right eye using the SMILE procedure. RESULTS: At the 2-year follow-up visit, the uncorrected distance visual acuity of the left eye had improved from 20/100 to 20/22 and the corrected distance visual acuity had improved from 20/25 to 20/18. Central corneal thickness had increased from 464 to 499 mu m. The mean keratometry value had decreased from 45.00 diopters (D) at the 1-month follow-up visit to 39.40 D at the 2-year follow-up visit. Optical coherence tomography examination revealed that the lenticule remained transparent and exhibited a visible demarcation line. CONCLUSIONS: The transplantation of an autologous lenticule obtained via SMILE combined with PTK improved uncorrected and corrected acuity in this patient with flap loss after LASIK.