Progressive keratectasia after laser in situ keratomileusis
Progressive keratectasia after laser in situ keratomileusis
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DOI：
10.3928/1081-597x-20040903-18
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发表时间：
2004-09-01
影响因子：
2.4
通讯作者：
Saifi, N
中科院分区：
文献类型：
--
作者：
Rad, AS;Jabbarvand, M;Saifi, N
目得：我们描述了10例进行性角膜扩张的激光原位角膜磨镶术（LASIK），并确定可能导致角膜扩张的因素：方法：在这项回顾性研究中，我们回顾了2000年3月至2003年4月3,634例（6941眼）LASIK患者的文件。10例患者（14只眼，0.2%）发生了进行性角膜扩张。我们还评估了随之而来的治疗措施和最终的视力状态，这些patients.RESULTS：患者进行了检查，平均24.9 +/- 8.1个月后LASIK。术后平均14 +/- 0.3个月内出现扩张。基线时，平均角膜屈光力为44.7 +/- 2.30 D，平均角膜厚度为516 +/- 18.9 μ m，平均矫正尝试为-10.85 +/- 3.20 D。我们发现残余基质厚度、矫正尝试和进行性角膜扩张发生率之间存在统计学显著相关性。我们还发现，预先存在的异常角膜地形图是进行性角膜扩张的危险因素。最后，大多数患者有合理的视力穿透keratoplasty.CONCLUSION：进行性角膜扩张是一个视力威胁并发症的LASIK，可能会发生在以前的健康或患病的眼睛。最重要的危险因素是残余基质厚度和先前存在的异常角膜地形图。穿透性角膜移植术可能是治疗严重进行性角膜扩张的一种合理方法。
PURPOSE: We describe ten patients who developed progressive keratectasia following laser in situ keratomileusis (LASIK) and identify possible factors that may lead to ectasia.METHODS: In this retrospective study, we reviewed the files of 3,634 patients (6941 eyes) who had LASIK between March 2000 and April 2003. Ten patients (14 eyes, 0.2%) developed progressive keratectasia. We also evaluated consequent therapeutic measures and final visual status of these patients.RESULTS: Patients were examined at a mean 24.9 +/- 8.1 months after LASIK. Ectasia developed within a mean 14 +/- 0.3 months after surgery. At baseline, mean keratometric power was 44.7 +/- 2.30 D, mean corneal thickness was 516 +/- 18.9 mum, and mean attempted correction was -10.85 +/- 3.20 D. We found a statistically significant correlation between residual stromal thickness, attempted correction, and occurrence of progressive keratectasia. We also found that preexisting abnormal corneal topography was a risk factor for progressive keratectasia. Ultimately, most patients had reasonable visual acuity after penetrating keratoplasty.CONCLUSION: Progressive keratectasia is a vision threatening complication of LASIK that may occur in previously healthy or diseased eyes. The most important risk factors are residual stromal thickness and preexisting abnormal corneal topography. Penetrating keratoplasty may be a reasonable therapeutic measure for severe cases of progressive keratectasia.