LASIK術後視網膜剝離的處理－病例報告

Management for Rhegmatogenous Retinal Detachment Following LASIK-A Case Report

李東昇(Tong-Sheng Lee) ； 唐甄蔚(Chen-Wei Tang) ； 鄭成國(Cheng-Kuo Cheng) ； 楊長豪(Chang-Hao Yang)

《中華民國眼科醫學會雜誌》 41卷4期 (2002/12) Pp. 559-563

https://doi.org/10.30048/ACTASOS.200212.0015

摘要

本文報告一位37歲女性於LASIK手術後54天發生裂孔性視網膜剝離，我們為其進行鞏膜扣壓術，在術中因張眼器及肌肉牽引線磨擦到角膜而發生角膜辦移位，術中雖然將flap完全復位，但術後12個月的追蹤，角膜仍然有些微的皺摺，矯正後最佳視力零點六，殘餘屈光度數為-2.50D Cyl-1.50D×20°。
在本篇文章中探討了LASIK術後發生裂孔性視網膜剝離進行鞏膜扣壓術中如何保護角膜，以及其它的替代手術方式對角膜瓣的影響及優劣，除此之外，本文也討論近視屈光手術與裂孔性視網膜剝離之間可能的相關性。

並列摘要

Purpose: To report a case of corneal flap dislocation while in scleral buckling procedure for rhegmatogenous retinal detachment after Laser in situ keratomileusis (LASIK).
Method: Case report
Result: A 37-year-old female patient suffered from sudden onset blurred vision and lower visual field defect in her right eye after 54 days of LASIK. A retinal flap tear with retinal detachment over the upper temporal quadrate was noted. Scleral buckling procedure was performed and corneal flap was dislocated during operation. Although the flap was relocated successfully and immediately, mild flap striate could still be noted after operation. The patient was followed for 12 months and retina was well attached. The final BCVA was 6/10 with a refractive error of -2.50D Cyl-l.50D×20°.
Conclusion: LASIK has become a very popular procedure recently. Rhegmatogenous retinal detachment (RRD) after LASIK will therefore be encountered more and more frequently. To know how to manage the RRD after LASIK and how to protect corneal flap is very important for retinal specialist nowadays. If cornea flap can be properly protected during operation, the prognosis of management of RRD after LASIK will probably not worse than RRD without LASIK. On the other hand, a throughout retinal examination and prompt treatment of any retinal lesion predisposing to the development of an RRD is also indispensable in order to lower the incidence of RRD after LASIK.

並列關鍵字

LASIK ； rhegmatogenous retinal detachment ； corneal flap