Laser-Assisted in Situ Keratomileusis (LASIK) Flap Suturing to Treat Late-Onset Traumatic flap Dehiscence and Striae

以瓣膜縫合術治療雷射屈光手術後晚期創傷性角膜瓣裂開及皺摺

李嘉宏(Chia-Hung Li) ； 王騰毅(Teng-Yi Wang) ； 洪世明(Shin-Ming Hung) ； 戴明正(Ming-Cheng Tai) ； 呂大文(Da-Wen Lu)

《中華民國眼科醫學會雜誌》 46卷2期 (2007/06) Pp. 123-128

https://doi.org/10.30048/ACTASOS.200706.0005

摘要

目的：報告4個LASIK手術後發生晚期創傷性角膜裂開的病例，討論基治療及結果。
方法：介入性病例報告－四例個案皆是在LASIK手術後約一年因眼球遭受機械性創傷導致角膜瓣裂開。
結果：病例一於打藍毬時，右眼受到手指戳傷，導致角膜瓣裂開，並於受傷報七天接受瓣膜縫合治療。同時也在病例一發現明顯的角膜上皮向內生長及多處角膜瓣皺摺。病例二則是在車禍中，右眼受到鈍傷而導致角膜瓣裂開，並於受傷後四小時即施行瓣膜縫合。病例三於運動時，右眼受到手指戳傷，導致角膜瓣裂開並移位，並於受傷後六小時施行瓣膜縫合。同時也在病例三發現角膜多處角膜瓣明顯的皺摺。病例四於打藍毬時，右眼受到手指戳傷，導致角膜瓣裂開並移位，並於受傷後六小時施行瓣膜縫合術的時間間隔皆約為一年。病例一的術前最佳矯正視力為零點六，病例二為零點一，病例三為零點三，病例四則為零點五。四個病例的角膜瓣皆從鼻側裂開。在手術時，裂開的角膜瓣被提、伸張、與縫合，並於手術結束時置放治療性隱形眼鏡。經過六個追蹤，病例一的未矯正視力為零點入，病例二、三、四為一點零。
結論：瓣膜縫合是治療雷射屈光手術後期創傷性角膜瓣裂開的有效方法。

並列摘要

Background: Traumatic dehiscence of the flap is an uncommon yet important cause of visual impairment following laser-assisted in situ keratomileusis (LASIK). In this report, we describe the management and outcome of flap suturing to manage late-onset traumatic LASIK flap dehiscence with striae in foul cases.
Methods: Case 1 underwent flap suturing seven days after ocular trauma n the right eye. Case 2, case 3 and case 4 underwent flap suturing four to six hours after blunt trauma to the right eye, right eye, and left eye, respectively Preoperative best spectacle-corrected visual acuity was 6/10 in case 1, 6160 in case 2, 6/20 in case 3 and 6/12 in case 4. The flaps were lifted, refloated, stretched, and sutured in these 4 cases.
Results: After six months of follow-up, the uncorrected visual acuity of case 1 was 6/5 and that of case 2, case 3 and case 4 was 6/6.
Conclusion: Flap suturing is an effective way of treating late-onset trauma tic flap dehiscence with prominent stiae.

並列關鍵字

Laser-assisted in situ keratomileusis LASIK ； LASIK flap dehiscence ； striae ； flap suturing