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目的 :探讨 L ASIK术后角膜上皮植入的发生、影响因素、处理方法和效果。方法 :回顾性分析由同一位医生所行 L ASIK术后随访 6个月以上并有完整记录的所有病例。结果 :共 63 3例病人 12 4 0只眼 ,其中 61眼曾行二次 L ASIK手术。有 10人 10眼 ( 0 .81% )发生角膜上皮植入。其中 ,1眼为二次手术后发生 ( 1.6% ) ;6眼有戴接触镜史 ;5眼术中发生瓣或上皮异常 :游离瓣 1眼、上皮缺损 2眼、上皮松解 2眼 ;6眼术后 1天时发现荧光素染色阳性 ( 5眼 )或角膜瓣皱折 ( 1眼 ) ;9眼上皮植入发生于角膜瓣的边缘 ,4眼见于原上皮缺损或易脱落方向。除 1眼待术外 ,其余 9眼 ( 5眼药物治疗 ,4眼手术治疗 )的最终裸眼视力为 0 .72± 0 .3 2 ( 0 .0 2～ 1.0 ) ,最佳矫正视力为 0 .93± 0 .1( 0 .8～ 1.0 ) ,球镜为 - 0 .3 1± 0 .97D( - 2 .2 5～ 1.5 D) ,柱镜为 0 .61± 0 .5 0 D( 0～ 1.2 5 D) ,无异物感、眩光、荧光素着染等 ,上皮植入消失 5眼 ,变小 1眼 ,静止 3眼。结论 :术者应通过提高手术操作技能和完善各手术步骤尽可能地减少此并发症的发生。发现后恰当处理 ,可获得很好效果。
Objective: To investigate the incidence, influential factors, treatment methods and effects of corneal epithelial implantation after LASIK. METHODS: All cases with a complete record of more than 6 months after LASIK performed by the same physician were retrospectively analyzed. Results: A total of 123 out of 63 patients with 120 eyes, of which 61 had a second LASIK surgery. Corneal epithelial implantation occurred in 10 eyes (0.81%) of 10 patients. Among them, 1 occurred after secondary surgery (1.6%); 6 eyes wear contact lenses history; 5 cases of valve or epithelial abnormalities occurred: 1 free flap, 2 epithelial defects, 2 epithelial release; 6 Fluorescein staining (5 eyes) or corneal flap rupture (1 eye) was found on day 1 postoperatively. 9 eyes had epithelial implantation at the edge of corneal flap, and 4 eyes were found in the original epithelial defect or easy to fall off. With the exception of 1 patient undergoing surgery, the remaining uncorrected visual acuity was 0.72 ± 0.32 (0 .0 2 to 1.0) in the remaining 9 eyes (5 eyes treated with medicine and 4 eyes treated with surgery), and the best corrected visual acuity was 0. 93 ± 0. 1 (0.8 ~ 1.0), the spherical scope was -0.31 ± 0.97D (-2.52 ~ 1.5D), the cylinder was 0.61 ± 0.5D (0 ~ 1.2 5 D), no foreign body sensation, glare, fluorescein staining, epithelial implantation disappeared 5 eyes, smaller 1, still 3 eyes. Conclusion: The surgeon should reduce the occurrence of this complication as much as possible by improving the operation skills and improving the surgical procedures. After the discovery of appropriate treatment, can be very effective.