雷射角膜層狀塑型術後瀰漫性層狀角膜炎之病例報告

Diffuse Lamellar Keratitis after Laser-In-Situ-Keratomileusis-Cases Report

沈應誠(Ying-Cheng Shen) ； 馮士釗(Shih-Chao Fong) ； 李怡芬(Yi-Fen Lee)

《中華民國眼科醫學會雜誌》 42卷4期 (2003/12) Pp. 436-442

https://doi.org/10.30048/ACTASOS.200312.0008

摘要

目的：報告3個LASIK手術後產生嚴重的瀰漫性層狀角膜炎(Diffuse lamellar keratitis, DLK)之病例，討論其發生原因、治療及預後。
方法：病例報告
結果：同一天共三個病人，六隻眼睛接受近視LASIK手術。手術皆順利完成，但於手術後隔天都產生瀰漫性層狀角膜炎。器械皆照平日的標準處理，但術後發現在器械盒內有一片因高溫消毒而變形的泡綿。在角膜界面之間的發炎皆使用積極的類固醇眼藥水治療。所有的發炎反應在治療之後都逐漸消散，只有二人於一週後在角膜中間剩下非常淡的疤痕。
結論：對於LASIK手術器械及用品的消毒必須特別小心，要注意是否有不耐高溫的物品存在，以免造成術後的發炎反應。

並列摘要

Purpose: To report three severe cases of diffuse lamellar keratitis (DLK) after laser in situ keratomileusis (LASIK), and discuss the etiology, treatment, and prognosis.
Method: Cases report.
Result: Six eyes of three young women have received technically smooth LASIK on the same day. DLK was found in all six eyes on the next day. All the procedures were performed and all the instruments were prepared the same as usual except a piece of sponge was accidentally put in the box for autoclave. The inflammation at the interface was treated aggressively with topical corticosteroid eyedrop and then progressively resolved and only minimal central opacification remained in two patients after one week treatment.
Conclusion: Surgeons should pay attention to the procedure of and avoid the existence of thermolabile materials to prevent DLK.

並列關鍵字

Diffuse lamellar keratitis DLK ； Laser-In-Situ-Keratomileusis ； LASIK ； Sands of the Sahara syndrome