Laser in situ keratomileusis-induced (presumed) neurotrophic epitheliopathy
Laser in situ keratomileusis-induced (presumed) neurotrophic epitheliopathy
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DOI：
10.1016/s0161-6420(01)00587-5
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发表时间：
2001-06-01
期刊：
影响因子：
13.7
通讯作者：
Wilson, SE
中科院分区：
文献类型：
--
作者：
Wilson, SE
目的：评价激光原位角膜磨镶术（LASIK）术后最初几个月角膜瓣上出现中度至重度虎红染色的患眼与角膜瓣上几乎没有或没有染色的患眼相比的泪液生成、角膜地形图、屈光矫正的准确性和最佳矫正视力。设计：回顾性病例对照研究。参与者：LASIK术后1 ~ 3个月19例中重度点状上皮糜烂和瓣上虎红染色的连续患者的个体眼与19例并发患者的眼进行比较，这些患者没有点状上皮糜烂或瓣上超过痕量染色。方法：采用非参数统计分析比较术后3个月和6个月的泪液分泌、角膜地形图不规则性、等效球镜和视力。两组中的一些眼在术后1个月也进行了泪液分泌分析。主要结果测量：无麻醉的Schirmer试验，角膜地形图不规则测量（CIM），尝试和实现的等效球镜之间的差异，以及最佳矫正视力的丧失。LASIK术后1、3或6个月，有点状上皮糜烂和瓣上虎红染色的患者与无点状上皮糜烂和瓣上虎红染色的患者的泪液分泌无差异。两组的CIM或屈光矫正的平均准确度没有显著差异，但有些患者的最佳矫正视力有短暂的下降。角膜瓣虎红染色解决6个月后，LASIK在大多数受影响的patients.Conclusions：LASIK诱导的虎红染色的患者没有预先存在的干眼可能是神经营养性上皮病，因为有没有显着的点状上皮糜烂和虎红染色的患者之间的平均泪液生产的差异发展的皮瓣和那些没有。LASIK诱导的（假定的）神经营养性上皮病的体征和症状倾向于在手术后约6个月消退。这种疾病往往是更常见和严重的患者与预先存在的干眼病。眼科学2001;108：1082-1087（C）2001，美国眼科学会。
Objective: To evaluate tear production, corneal topography, accuracy of refractive correction, and best spectacle-corrected visual acuity in eyes that had moderate to severe rose bengal staining develop on the flap compared with eyes with little or no staining on the flap, the first few months after laser in situ keratomileusis (LASIK). None of the eyes in this study had significant preoperative dry eye disease.Design: Retrospective case control study.Participants: Individual eyes of 19 consecutive patients with moderate to severe punctate epithelial erosions and rose bengal staining on the flap 1 to 3 months after LASIK were compared with eyes of 19 concurrent patients who did not have punctate epithelial erosions or more than trace staining on the flap develop.Methods: Nonparametric statistical analyses were used to compare tear secretion, corneal topographic irregularity, spherical equivalent, and visual acuity 3 and 6 months after surgery. Some eyes in both groups also had analysis of tear secretion 1 month after surgery.Main Outcome Measures: Schirmer's test without anesthesia, the topographic corneal irregularity measurement (CIM), the difference between attempted and achieved spherical equivalent, and the loss of best spectacle-corrected visual acuity.Results: There was no difference in tear production 1, 3, or 6 months after LASIK in patients who had punctate epithelial erosions and rose bengal staining on the flap develop and those who did not. There was no significant difference in the CIM or mean accuracy of the refractive correction in the two groups, but some patients had a transient decrease in best spectacle-corrected visual acuity. Flap rose bengal staining resolved by 6 months after LASIK in most affected patients.Conclusions: LASIK-induced rose bengal staining in patients without preexisting dry eye is likely neurotrophic epitheliopathy, because there is no difference in mean tear production between patients who have significant punctate epithelial erosions and rose bengal staining develop on the flap and those who do not. The signs and symptoms of LASIK-induced (presumed) neurotrophic epitheliopathy tend to resolve approximately 6 months after surgery. This disorder tends to be more common and severe in patients with pre-existing dry eye disease. Ophthalmology 2001;108:1082-1087 (C) 2001 by the American Academy of Ophthalmology.